丁苯酞序贯治疗急性脑梗死合并认知功能障碍患者的疗效及其对炎性因子的影响  

Butylphthalide soft capsules sequential treatment of acute cerebral infarction patients with cognitive dysfunction and its effects on inflammatory factors

作　　者：陈娜[1] 陆连生[1] 李虹[1] 王聪杰[1] 卢海丽[1] 李婧[1] 吕晓培[1] 郑丽[1] 张斌[1] 宋海霞[1] 史万英[1] CHEN Na LU Liansheng LI Hong WANG Congjie LU Haili LI Jing LV Xiaopei ZHENG Li ZHANG BIN SONG Haixia SHI Wanying(Third Department of Neurology, the First Hospital of Shifiazhuang, Shijiazhuang 050011, China)

机构地区：[1]石家庄市第一医院神经内三科,050011

出　　处：《疑难病杂志》2017年第2期117-120,126,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：河北省卫计委2015年度医学科学研究重点课题计划项目(20150919)

摘　　要：目的观察丁苯酞序贯治疗急性脑梗死合并认知功能障碍患者的疗效及其对炎性因子的影响。方法收集分析2012年6月—2015年6月石家庄市第一医院神经内三科收治的急性脑梗死合并认知功能障碍患者106例的临床资料。随机数字表法分为2组,每组53例。对照组患者应用丁苯酞注射液14d后未给予特殊治疗,观察组患者应用丁苯酞注射液14d后继续口服丁苯酞胶囊3个月。3个月后观察2组患者的临床治疗效果,急性脑卒中患者的神经功能缺损评分(NIHSS评分)、日常生活能力(Barthel评分)、简易精神状态量表(MMSE)评分,炎性因子[高敏C反应蛋白(hs-CRP)、五聚素-3(PTX-3)]变化及不良反应。结果对照组总有效率为81.13%低于观察组的98.11%(X^2=16.74,P<0.01)。与治疗前比较,2组治疗3个月后NIHSS评分均降低,Barthel评分、MMSE评分均升高(t_观=5.03、27.36、4.21,P<0.05,t_对=2.45、12.54、2.36,P均<0.05),且观察组改善优于对照组(t=5.8、9.4、53.7,P<0.05);观察组治疗后hs-CRP、PTX-3水平均降低(t=5.36、6.75,P<0.05),且观察组变化优于对照组(t=6.78、4.45,P<0.05)。治疗期间对照组出现胃肠道不适1例,观察组睡眠欠佳1例,2组患者均未发现其他不良反应。结论丁苯酞序贯治疗可以使急性脑梗死合并认知功能障碍患者恢复快、预后好,值得在临床推广使用。Objective To observe the effect of butylphthalide sequential therapy in patients with acute cerebral infarction with cognitive impairment and effect on inflammatory laclors.Methods The clinical data of 106 patients with acute cerebral infarction complicated with cognitive impairment in the neurology of first hospital of Shijiazhuang from June 2012 to June 2015 were analyzed retrospectively.106 cases were randomly divided into 2 groups,53 cases in each group.The control group was treated with butylphthalide injection 14 d without special treatment,the observation group was treated with butylphthalide injection 14 d after continuous oral administration of dl 3 butylphthalide for 3 months.To observe the clinical therapeutic effect of 2 groups of patients after 3 months,the neurological deficit score in patients with acute stroke（NIHSS score）,ability of daily life（Rarthel score）,Mini Mental State Scale（MMSE） score,inflammatory factors and adverse reactions were compared.Results The total effective rate of the control group was 98.11%,which lower than that of the observation group＇s 81.13%（x^2 = 16.74,P〈0.01）.Compared with before treatment,90 day after treatment,the NIHSS scores of the 2 groups were decreased,Barthel score and MMSE score were significantly increased（t =5.03,t =27.36,t =4.21,P〈0.05,t=2.45,t= 12.54,t=2.36,P〈0.05）,and the observation group were better than the control group（χ^2=5.8.χ^2=9.4,χ^2=53.7,P〈0.05）.After treatment,the 2 groups＇ hs CRP,PTX 3 levels were reduced than before treatment（t =5.36,6.75,P〈0.05）,and the observation group was better than the control group,the difference was statistically significant（t =6.78,4.45,P〈0.05）.During the treatment,1 case of gastrointestinal discomfort occurred in the control group,the observation group of 1 case had poor sleep,and 2 groups of patients were not lound other adverse reactions.Conclusion Sequential therapy of butylphthalide can make patients with acute cerebral infarction with cognitive dysfunction re

关 键 词：丁苯酞 序贯治疗 脑梗死 急性 认知功能障碍 炎性因子 

分 类 号：R749.13[医药卫生—神经病学与精神病学]