神经节苷脂联合丁苯酞治疗急性分水岭脑梗死的临床疗效及其对血液流变学和血清同型半胱氨酸水平的影响研究  

Clinical Effect of Ganglioside Combined with Butylphthalide on Acute Cerebral Watershed Infarction and the Impact on Hemorheology and Serum Homocysteine Level

作　　者：唐彦[1] 张凡[2] 窦艳霞[2] 马萍[2] 纪光[3] 

机构地区：[1]河北省保定市第二中心医院神经内一科,072750 [2]河北廊坊长征医院神经内科,河北省廊坊市065000 [3]河北工业大学校医院内科,天津市300401

出　　处：《实用心脑肺血管病杂志》2017年第3期42-45,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的观察神经节苷脂联合丁苯酞治疗急性分水岭脑梗死(ACWI)的临床疗效,探讨其对血液流变学、血清同型半胱氨酸(Hcy)水平的影响。方法选取2014年1月—2016年8月保定市第二中心医院收治的ACWI患者80例,采用随机数字表法分为对照组与观察组,每组40例。在常规治疗基础上,对照组患者予以注射用单唾液酸四己糖神经节苷脂钠治疗,观察组患者在对照组基础上加用丁苯酞软胶囊治疗;两组患者均连续治疗2周。比较两组患者临床疗效,治疗前后血清神经生长因子(NGF)、Hcy水平和血液流变学指标,治疗前及治疗1、2周美国国立卫生研究院卒中量表(NIHSS)评分,并观察两组患者治疗期间不良反应发生情况。结果观察组患者临床疗效优于对照组(P<0.05)。治疗前两组患者血清NGF、Hcy水平比较,差异无统计学意义(P>0.05);治疗后观察组患者血清NGF水平高于对照组,血清Hcy水平低于对照组(P<0.05)。治疗前两组患者血浆黏度、全血低切黏度、全血中切黏度、全血高切黏度、红细胞聚集指数比较,差异无统计学意义(P>0.05);治疗后观察组患者血浆黏度、全血低切黏度、全血中切黏度、全血高切黏度、红细胞聚集指数低于对照组(P<0.05)。治疗前两组患者NIHSS评分比较,差异无统计学意义(P>0.05);治疗1、2周观察组患者NIHSS评分低于对照组(P<0.05)。两组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论神经节苷脂联合丁苯酞治疗ACWI的临床疗效确切,可有效改善患者神经功能及血液流变学指标,降低血清Hcy水平,且安全性较高。Objective To observe the clinical effect of ganglioside combined with butylphthalide on acute cerebral watershed infarction, to explore the impact on hemorheology and serum homocysteine level. Methods A total of 80 patients with acute cerebral watershed infarction were selected in the Sec0nd Central Hospital of Baoding from January 2014 to August 2016, and they were divided into control group and observation group according to random number table, each of 40 cases. Based on conventional treatment, patients of control group received monosialotetrahexosyl ganglioside sodium for injection, while patients of observation group received monosialotetrahexosyl ganglioside sodium for injection combined with butylphthalide soft capsules; both groups continuously treated for 2 weeks. Clinical effect, serum levels of NGF and homocysteine, imlex of hemorheology before and after treatment, NIHSS score before treatment, after 1 week and 2 weeks of treatment were compared between the two groups, and incidence of adverse reactions was observed during the treatment. Results Clinical effect of observation group was statistically significantly better than that of control group （P 〈 0. 05）. No statistically significant differences of serum level of NGF or homocysteine was found between the two groups before treatment （ P 〉 0. 05） ; after treatment, serum NGF level ofobservation group was statistically significantly higher than that of control group, while serum homocysteine level of ohservation group was statistically significantly lower than that of control group （ P 〈 0. 05 ）. No statistically significant differences of plasma viscosity, whole low - shear blood viscosity, whole middle - shear blood viscosity, whole high - shear blood viscosity or erythrocyte aggregation index was found between the two groups before treatment （ P 〉 0. 05）, while plasma viscosity, whole low -shear blood viscosity, whole middle -shear blood viscosity, index of observation group were statistically significantly lower whole high

关 键 词：脑梗死 血液流变学 同型半胱氨酸 神经节苷脂 丁苯酞 治疗结果 

分 类 号：R743.33[医药卫生—神经病学与精神病学]