左西孟旦联合丁苯酞对脑梗死患者血清MMP-9及血流动力学影响  

Effect of levosimendan combined with butyphthalide on serum MMP-9 and hemodynamics in cerebral infarction

作　　者：章凯[1] 胡北平[1] 

机构地区：[1]湖州市中心医院重症医学科,浙江湖州313000

出　　处：《中国生化药物杂志》2016年第10期54-57,共4页Chinese Journal of Biochemical Pharmaceutics

摘　　要：目的探讨左西孟旦联合丁苯酞对脑梗死患者血清基质金属蛋白酶-9(matrix metalloproteinases-9,MMP-9)及血流动力学的影响。方法选取研究对象为74例急性脑梗死患者,随机分成2组,每组37例。均接受控制血压、血糖,神经营养、抗血小板、脱水降颅内压等常规治疗,在此基础上对照组予以丁苯酞注射液静点,研究组在上述治疗基础上再予以左西孟旦静点。检测治疗前后血清相关指标及血流动力学变化,并对神经功能及日常生活的活动能力进行评估,比较临床疗效。结果与治疗前比较,2组超氧化物歧化酶(superoxide dismutase,SOD)水平升高(P<0.01),丙二醛(malondialdehyde,MDA)水平降低(P<0.01),超敏C-反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)及MMP-9水平均降低(P<0.01),全血高切黏度、全血低切黏度、血浆黏度以及红细胞压积均降低(P<0.05),美国国立卫生院神经功能缺损(NIHSS)评分降低(P<0.01),日常生活能力(BI)评分升高(P<0.01);与对照组比较,研究组SOD水平较高(P<0.01),MDA水平较低(P<0.01),hs-CRP、Hcy及MMP-9水平均较低(P<0.01),全血高切黏度、全血低切黏度、血浆黏度以及红细胞压积均较低(P<0.05),NIHSS评分较低(P<0.01),BI评分较高(P<0.01),治疗有效率较高(P<0.05)。结论左西孟旦联合丁苯酞可明显减轻脑梗死患者症状,改善血流动力学,降低血清MMP-9水平。Objective To investigate the effects of levosimendan combined with butyphthalide on serum MMP-9 and hemodynamics in the treatment of cerebral infarction in patients. Methods 74 patients with acute cerebral infarction were selected and randomly divided into two groups,37 cases in each group. All patients received control of blood pressure,blood glucose,nerve nutrition,anti platelet,dehydration and lowering intracranial pressure and other conventional treatment,the control group received butyphthalide,and the experimental group received more with levosimendan.Serum related parameters and hemodynamics,neurological function and activities of daily living,clinical efficacy were compared after the treatment.Results Compared with before treatment,levels of SOD increased in the two groups（ P〈0. 01）,levels of MDA decreased（ P〈0. 01）,hs-CRP,Hcy and MMP-9 decreased（ P〈0. 01）,whole blood viscosity,whole blood low shear viscosity,plasma viscosity and hematocrit decreased（ P〈0. 05）,NIHSS scoredecreased（ P〈0. 01）,the BI score increased（ P〈0. 01）. Compared with the control group,levels of SOD in experimental group was higher（ P〈0. 01）,the level of MDA was lower（ P〈0. 01）,hs-CRP,Hcy and MMP-9 were lower（ P〈0. 01）,whole blood viscosity,whole blood low shear viscosity,plasma viscosity and hematocrit were lower（ P〈0. 05）,NIHSS scores were lower（ P〈0. 01）,BI score were higher（ P〈0. 01）,the effective rate of treatment was higher（ P〈0. 05）. Conclusion Levosimendan combined with butylphthalide can obviously alleviate the symptoms of patients with cerebral infarction,improve the hemodynamics,reduce the level of serum MMP-9.

关 键 词：脑梗死 左西孟旦 丁苯酞 血流动力学 MMP-9 

分 类 号：R543[医药卫生—心血管疾病]