舌下含服卡托普利对急性缺血性脑卒中患者的急救效果及血清8-isoPGF2α ox-LDL PARK7的影响  

Effect of Sublingual Captopril on Emergency Treatment and Serum Levels of 8-isoPGF2 Alpha ox-LDL and PARK7 in Patients with Acute Ischemic Stroke

作　　者：孙宝存[1] 董科 朱爱华[1] 王丽萍[1] SUN Baocun(Tangshan People＇s Hospital,Hebei Tangshan 063000,China)

机构地区：[1]河北省唐山市人民医院急诊科,河北唐山063000 [2]华北理工大学附属医院肾内科,河北唐山063000

出　　处：《河北医学》2018年第11期1812-1817,共6页Hebei Medicine

基　　金：2018年度河北省医学科学研究重点课题计划;(编号:20181264)

摘　　要：目的:探讨舌下含服卡托普利对急性缺血性脑卒中患者的急救效果及血清8-异列腺素F2α(8-iso PGF2α)、氧化低密度脂蛋白(ox-LDL)、帕金森蛋白7(PARK7)的影响。方法:选择2016年2月至2018年2月我院接诊的91例急性缺血性脑卒中患者作为本研究对象,通过简单随机数表法分为观察组46例和对照组45例,对照组给予常规治疗,观察组在对照组基础上,给予卡托普利片舌下含服治疗,两组均连续治疗14d。比较两组临床疗效、美国国立卫生研究院卒中量表(NIHSS)评分、日常生活能力(Barthel指数)、血脂指标、血清8-isoPGF2α、ox-LDL、PARK7的变化。结果:治疗后,观察组临床疗效总有效率为91.30%(42/46),明显比对照组的73.33%(33/45)高(P<0.05);和治疗前比较,两组治疗后NIHSS评分、Barthel指数均得到明显改善(P<0.05),且观察组NIHSS评分明显低于对照组,Barthel指数明显比对照组高(P <0.05);和治疗前比较,两组治疗后血脂指标均得到明显改善(P <0.05),且观察组总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-L)明显低于对照组,高密度脂蛋白胆固醇(HDL-C)明显比对照组高(P<0.05);治疗后,两组血清8-isoPGF2α、ox-LDL、PARK7均明显低于治疗前(P<0.05),观察组血清8-isoPGF2α、ox-LDL、PARK7均明显低于对照组[(352.30±32.01)μg/dl VS(398.45±39.45)μg/dl,(7.30±1.24) pg/m L VS(9.94±1.75) pg/m L,(19.42±2.32)μg/L VS(25.87±2.95)μg/L](P <0.05);两组治疗期间均无严重不良反应,未发生脑出血患者,观察组有2例患者出现皮疹并合并瘙痒,停药后自行缓解无需特殊处理。结论:在急性缺血性脑卒中患者急救中使用舌下含服卡托普利效果显著,有助于改善神经功能,其内在机制可能和降低血清8-iso PGF2α、ox-LDL、PARK7表达、缓解机体氧化应激反应等途径相关。Objective： To investigate the effect of sublingual captopril on emergency therapy of acute ischemic stroke and the effects of serum 8-Isoprostaglandin F2 alpha （8-isoPGF2 alpha）, oxidized low-densitylipoprotein （ox-LDL） and Parkinson＇s protein 7 （PARK7）. Methods： 91 patients of acute ischemic strokereceived treatment from February 2016 to February 2018 in our hospital were selected as research objects, according to the smiple random number table. All those patients were divided into the 46 cases of observationgroup and the 45 cases control group. The control group was given routine treatment, the observation group wasgiven captopril tablets sublingual treatment on the basis of the control group. The two groups were treated continuously for 14d. The clinical efficacy, NIHSS score, Barthel index, blood lipid index, serum 8-isoPGF2a,ox-LDL and PARK7 were compared between the two groups. Results： After treatment, the total effective rateof the observation group was 91.30% （42 / 46）, which was significantly higher than that of the control group73.33% （33 / 45） （P 〈0.05）. Compared with those before treatment, the NIHSS score and Barthel index ofthe two groups improved significantly after treatment （P〈0.05）, the NIHSS score in the observation group wassignificantly lower than that of the control group, and the Barthel index was significantly higher than that of thecontrol group （P〈0.05）. Compared with those before treatment, the blood lipid indexes of the two groups weresignificantly improved after treatment （P 〈0.05）, the total cholesterol （ TC）, three glycerol （ TG） and lowdensity lipoprotein cholesterol （LDL-L） in the observation group were significantly lower than that of the control group, and the high density lipoprotein cholesterol （HDL-C） was significantly higher than that of the control group （P〈0.05）. After treatment, the serum 8-isoPGF2α, ox-LDL and PARK7 levels in the two groupswere significantly lower than those before treatment （P

关 键 词：急性缺血性脑卒中 卡托普利 8-异列腺素F2α 氧化低密度脂蛋白 帕金森蛋白7 

分 类 号：R743.3[医药卫生—神经病学与精神病学]