丁苯酞联合阿替普酶对急性脑梗死患者神经功能、认知功能和Hcy等血清学指标的影响  

Effects of Butylphthalide Combined with Alteplase on Neural Function and Cognitive Function and Serological Indexes as Hcy in Patients with Acute Cerebral Infarction

作　　者：朱烨[1] 吴雅利[1] 李宝香[1] 何静[1] ZHU Ye;WU Yali;LI Baoxiang;HE Jing(First Dept.of Inpatient,Jiangxi Provincial People’s Hospital,Nanchang 330006,China)

机构地区：[1]江西省人民医院住院部一部,南昌330006

出　　处：《中国药房》2018年第8期1095-1098,共4页China Pharmacy

基　　金：江西省科技计划项目(No.赣科发计字[2015]179号-2015ZBBG70028)

摘　　要：目的:观察丁苯酞联合阿替普酶对急性脑梗死(ACI)患者神经功能、认知功能和同型半胱氨酸(Hcy)等血清学指标的影响。方法:回顾性分析2014年2月-2017年4月我院急诊科收治的78例ACI患者的临床资料,根据治疗方案将患者分为对照组及观察组,各39例。两组患者均给予常规治疗,同时口服阿司匹林肠溶片,对照组患者在此基础上给予注射用阿替普酶0.9 mg/kg静脉溶栓治疗,观察组患者在对照组基础上口服丁苯酞软胶囊0.2 g,tid。两组患者均连续治疗28 d。观察两组患者的临床疗效,治疗前及治疗后3、7、14、28 d时的美国国立卫生研究院卒中量表(NIHSS)及简易智力状况检查法(MMSE)评分,治疗前后Hcy、神经元特异性烯醇化酶(NSE)及6-酮-前列腺素-F1a(6-k-PGF1a)水平,并记录不良反应发生情况。结果:治疗后,观察组患者的总有效率为92.31%,显著高于对照组的71.79%,差异有统计学意义(P<0.05)。治疗后3~28 d,两组患者的NIHSS评分均逐渐降低,且显著低于治疗前,MMSE评分均逐渐升高,且显著高于治疗前,差异均有统计学意义(P<0.05或P<0.01);治疗后7~28 d,观察组患者的NIHSS评分显著低于对照组同期,MMSE评分显著高于对照组同期,差异均有统计学意义(P<0.05或P<0.01)。治疗后,两组患者的血清Hcy、NSE水平均显著降低,且观察组显著低于对照组,6-酮-前列腺素-F1a(6-k-PGF1a)水平均显著升高,且观察组显著高于对照组,差异均有统计学意义(P<0.05或P<0.01)。两组患者不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:丁苯酞联合阿替普酶可明显改善ACI患者神经功能缺损及认知障碍,降低其血清Hcy、NSE水平,升高6-k-PGF1a水平,临床疗效优于单用阿替普酶。OBJECTIVE:To observe the effects of butylphthalide combined with alteplase on neural funetion and cognitive function and serological indexes as homocysteine(Hcy)in patients with acute cerebral infarction(ACI).METHODS:Clinical information of 78 ACI patients in emergency department of our hospital during Feb.2140-Apr.2017 were analyzed and then divided into control group and observation group according to therapy plan,with 39 cases in each group.Both groups received conventional treatment and Aspirin enteric-coated tablets orally.Control group was given Alteplase for injection 0.9 mg/kg for verous thromblysis on the basis of conventional treatment.Observation group was additionally given Butyphthalide soft capsules 0.2 g orally,tid,on the basis of control group.Both groups were treated for consecutive 28 days.The clinical efficacies of 2 groups were observed.NIHSS and MMSE scores before treatment,3,7,14 and 28 d after treatment,the levels of Hcy,NSE and 6-k-PGF1a were observed in 2 groups;the occurrence of ADR was recorded.RESULTS:After treatment,total response rate of observation group was 92.31%,which was significantly higher than 71.79%of control group,with statistical significance(P<0.05).3-28 d after treatment,NIHSS scores of 2 groups were decreased gradually and significantly lower than before treatment;MMSE scores of 2 groups were increased gradually and significantly higher than before treatment,with statistical significance(P<0.05 or P<0.01).7-28 d after treatment,NIHSS score of observation group was significantly lower than that of control group at same time,while MMSE score was significantly higher than control group,with statistical significance(P<0.05 or P<0.01).After treatment,serum levels of Hcy and NSE in 2 groups were decreased significantly,and observation group was significantly lower than control group;the level of 6-k-PGF1a was increased significantly,and observation group was significantly higher than control group,with statistical significance(P<0.05 or P<0.01).There was no statistical signif

关 键 词：急性脑梗死 丁苯酞 阿替普酶 神经认知 认知功能 同型半胱氨酸 

分 类 号：R743.3[医药卫生—神经病学与精神病学]