丁苯酞联合阿司匹林、氯吡格雷抗血小板治疗进展性脑梗死的神经保护作用研究  

Neuroprotective effect of butylphthalide combined with aspirin and clopidogrel antiplatelet therapy for progressive cerebral infarction

作　　者：何兴兵[1] 

机构地区：[1]陕西省安康市中心医院,陕西安康725000

出　　处：《海南医学院学报》2016年第22期2677-2680,共4页Journal of Hainan Medical University

基　　金：陕西省科技攻关项目(2013JM4053)~~

摘　　要：目的:分析丁苯酞联合阿司匹林、氯吡格雷抗血小板治疗进展性脑梗死的神经保护作用。方法:86例进展性脑梗死患者随机分为观察组及对照组各43例,对照组接受阿司匹林、氯吡格雷抗血小板治疗,观察组接受丁苯酞联合阿司匹林、氯吡格雷抗血小板治疗,对比两组治疗后血小板功能、凝血功能、大脑中动脉血流状态及神经功能指标含量差异。结果:治疗1个疗程后,观察组血小板表面P-选择素、GPⅡb/Ⅲa的相对含量以及血浆中TXB2、vWF、D-D的含量均显著低于对照组,血浆中6-Keto-PGF1α的含量显著高于对照组;血栓弹力图指标R、K值高于对照组,MA、Angle、CI值低于对照组;大脑中动脉PSV、EDV、Vm、PI高于对照组,RI值低于对照组;血浆神经功能指标BDNF、H2S含量高于对照组,NSE、MBP、S100B、MMP-9含量低于对照组(P<0.05)。结论:丁苯酞联合阿司匹林、氯吡格雷抗血小板治疗可有效优化进展性脑梗死患者的血小板及凝血功能,促进大脑中动脉血流恢复并发挥积极的神经功能保护作用。Objective.. To analyze the neuroprotective effects of butylphthalide combined with aspirin and clopidogrel an- tiplatelet therapy for progressive cerebral infarction. Methods.. A total of 86 patients with progressive cerebral infarction were randomly divided into observation group and control group （n =43）, control group received aspirin and clopidogrel antiplatelet therapy, observation group received butylphthalide combined with aspirin and clopidogrel antiplatelet therapy, and then the differences in platelet function, blood coagulation function, middle cerebral artery blood flow state and nerve function index lev- els were compared between two groups after treatment. Results.. After 1 course of treatment, the relative content of P-selectin and GP Ⅱ b/Ⅲ a on platelet surface as well as TXB2, vWF and D-D content in plasma of observation group were significantly lower than those of control group, while 6-Keto-PGF1α content in plasma was significantly higher than that of control group; thrombelastogram indexes R and K value were higher than those of control group while MA, Angle and CI value were lower than those of control group; middle cerebral artery PSV, EDV, Vm and PI were higher than those of control group while RI value was lower than that of control group; nerve function indexes BDNF and H2 S content in plasma were higher than those of control group while NSE, MBP, S100B and MMP-9 content were lower than those of control group （P〈0.05）. Conclusion： Butylphthalide combined with aspirin and clopidogrel antiplatelet therapy can effectively optimize the platelet and blood coagula- tion function in patients with progressive cerebral infarction, promote the middle cerebral artery blood flow recovery and exert positive neuroprotective effect.

关 键 词：进展性脑梗死 丁苯酞 抗血小板 神经保护 

分 类 号：R743.3[医药卫生—神经病学与精神病学]