丁苯酞对急性脑梗死患者血管内皮生长因子、肿瘤坏死因子α及神经功能的影响  

Effect of Dl-3-n-butylphthalide Injection on Vascular Endothelial Growth Factor and Tumor Necrosis Factor α in Serum of Patients with Acute Cerebral Infarction

作　　者：李强[1] 田文艳[1] 陈立英[1] 王楚涵[1] 蔡芸[1] 金鑫[1] 

机构地区：[1]河北大学附属医院神经内科,河北保定071000

出　　处：《医学综述》2017年第5期1001-1005,共5页Medical Recapitulate

基　　金：河北省科技计划项目(12277706)

摘　　要：目的观察丁苯酞对急性脑梗死患者血清血管内皮生长因子(VEGF)、肿瘤坏死因子α(TNF-α)及神经功能的影响。方法选取2013年12月至2015年10月在河北大学附属医院神经内科住院治疗的急性脑梗死患者(发病24 h内)144例,按随机数字法分为观察组和对照组,各72例。对照组采用常规治疗(阿司匹林200 mg/d+阿托伐他汀20 mg/d+血栓通0.45 g/d),观察组在常规治疗的基础上加丁苯酞注射液静脉滴注,每次25 mg,每日2次,治疗14 d。观察入院时、治疗7、14 d血清VEGF、TNF-α水平,及美国国立卫生研究院卒中量表(NIHSS)评分;3个月Barthel指数评分。结果治疗后7、14 d两组血清VEGF和TNF-α水平较治疗前先升高后降低,观察组治疗后7、14 d血清VEGF水平高于对照组,血清TNF-α水平低于对照组,两组在组间、时点间、组间·时点间交互作用比较差异有统计学意义(P<0.01);两组治疗后7、14 d NIHSS评分较治疗前呈下降趋势,观察组下降速度更快两组在组间、时点间、组间·时点间交互作用比较差异有统计学意义(P<0.01)。治疗后3个月两组Barthel指数评分均较治疗前显著升高,且观察组显著高于对照组[(69.9±5.2)分比(58.7±4.7)分](P<0.01)。结论丁苯酞注射液治疗可以降低急性脑梗死患者血清TNF-α水平及提高VEGF水平,降低NIHSS评分,能明显提高患者的神经功能以及日常生活能力。Objective To observe the effect of dl-3-n-butylphthalide injection on serum vascular endothelial growth factor（VEGF）, tumor necrosis factor α （TNF-α） and neurological function in patients with acute cerebral infarction. Methods From Dec. 2013 to Oct. 2015, a total of 144 patients with acute cerebral infarction （within 24 hours after onset） admitted to the Department of Neurology, Affiliated Hospital of Hebei University were enrolled prospectively, The patients were divided into a control group （n = 72） and an observation group （n = 72） according to the random number method. The control group was given aspirin therapy（200 rag/d） ＋ atorvastatin（20 mg/d） ＋ Xueshuantong （0. 45 g/d）- The observa- tion group was given dl-3-n-butylphthalide injection（25 mg per time,2 times per day! on the basis of therapy in the control group. The treatment was lasted for 14 days. The level of serum VEGF,TNF-ot and the National Institute of Health Stroke Scale（NIHSS） score were observed at admission, after 7,14 d of treatment, and Barthe! Index score was assessed 3 month after treatment. Results The serum VEGF and TNF-α level were increased firstly and then decreased, in the two groups after 7 d and 14 d of treatment compared with before treatment, there were significant differences between groups, time points and groups time points （ P 〈 0. 01 ）. NIHSS score decreased than before treatment, and the observation group decreased fas- ter, there were significant difference between groups ,time points and groups ~ time points（ P 〈 0. 01 ）. 3 month after treat- ment, Barthel index of the two groups increased than before treatment, and the observation group was higher than that in the control group[ （69. 9 ~ 5.2） score vs （58. 7 ~ 4. 7 ） score ] （P 〈 0. 01 ）. Conclusion D1-3-n-butylphthalide injection can improve the serum VEGF level, reduce serum TNF-ct level and NIHSS score, and significantly improve the neurological function and daily living ability of the patients.

关 键 词：脑梗死 丁苯酞 血管内皮生长因子 肿瘤坏死因子Α 

分 类 号：R743[医药卫生—神经病学与精神病学]