丁苯酞序贯疗法联合奥扎格雷钠治疗短暂性脑缺血发作患者的临床研究  

Clinical trial of butylphthalide sequential therapy combined with ozagrel sodium in patients with transient ischemic attack

作　　者：王明玉[1] 杨茹[2] 何明利[2] 籍牛[1] WANG Ming-yu;YANG Ru;HE Ming-li;JI Niu(Department of Neurology,Lianyungang First People's Hospital,Lianyungang 222002,Jiangsu Province,China;Department of Internal Medicine-Neurology,Lianyungang First People's Hospital,Lianyungang 222002,Jiangsu Province,China)

机构地区：[1]连云港市第一人民医院神经功能科,江苏连云港222002 [2]连云港市第一人民医院神经内科,江苏连云港222002

出　　处：《中国临床药理学杂志》2019年第20期2531-2534,共4页The Chinese Journal of Clinical Pharmacology

基　　金：江苏省科技厅临床医学科技专项基金资助项目(BL2014062);江苏省卫生厅科研基金资助项目(H2014061)

摘　　要：目的观察丁苯酞序贯疗法联合奥扎格雷钠对短暂性脑缺血发作(TIA)患者神经功能和脑氧代谢的影响。方法将106例TIA患者随机分为对照组和试验组,每组53例。对照组给予奥扎格雷钠,每次80mg,溶于0.9%NaCl溶液250mL中,静脉滴注。试验组在对照组的基础上给予丁苯酞序贯,首先用丁苯酞氯化钠注射液治疗,每次25mg,静脉滴注,每日2次;之后用丁苯酞软胶囊治疗,每次0.2g,2组患者均连续治疗1个月。观察2组患者治疗前后的脑氧代谢情况、纤维蛋白原(FIB)、三酰甘油(TG)、神经功能因子水平、颈动脉内膜中层厚度(CIMT)、斑块面积变化情况及复发率。结果治疗后,试验组SjvO2、CjvO2水平(65.46±7.72)×10^-2,(114.58±9.81)mL·L^-1,对照组分别为(55.31±6.03)×10^-2,(99.16±8.47)mL·L^-1,差异均有统计学意义(均P<0.05)。治疗后,试验组和对照组FIB分别为(2.04±0.26),(2.48±0.51)g·L^-1,TG分别为(2.05±0.26),(2.61±0.23)mmol·L^-1,差异均有统计学意义(均P<0.05)。治疗后,试验组神经元特异烯醇化酶(NSE)、胶质纤维酸性蛋白(GFAP)、S^-100B蛋白、CIMT及斑块面积分别为(7.71±1.76)μg·L^-1,(0.88±0.42)ng·L^-1,(0.52±0.14)μg·L^-1,(0.78±0.22)mm,(19.08±4.15)mm^2;对照组分别为(9.68±2.13)μg·L^-1,(1.35±0.31)ng·L^-1,(0.64±0.23)μg·L^-1,(1.47±0.24)mm,(21.86±4.46)mm^2,差异均有统计学意义(均P<0.05)。治疗后3,6,9个月内的复发率比较,试验组患者复发率均低于对照组(P<0.05)。治疗期间,2组患者的药物不良反应发生率差异无统计学意义(P>0.05)。结论丁苯酞序贯疗法联合奥扎格雷钠较单独使用奥扎格雷钠对TIA患者的治疗效果较好,可显著改善患者的脑能量代谢和缺血脑区的微循环,优化脑氧代谢情况,控制局部脑缺血的梗死面积,显著改善患者神经功能,复发率低。Objective To explore the effects of butylphthalide sequential therapy combined with ozagrel sodium on neurological function and cerebral oxygen metabolism in patients with transient ischemic attack(TIA).Methods A total of 106 patients with TIA were randomly divided into control group and treatment group,with 53 cases in each group.Control group was treated with ozagrel sodium 80 mg,dissolved into0.9%NaCl solution 250 mL for intravenous drip,and treatment group was treated with butylphthalide sequential therapy on the basis of control group,first given butylphthalide sodium chloride injection 25 mg,intravenous drip,twice a day,then given butylphthalide soft capsules,0.2 g.Both groups were treated continuously for one month.The cerebral oxygen metabolism,levels of fibrinogen(FIB),triglyceride(TG),and neurological function factors,carotid intima-media thickness(CIMT),plaque area and recurrence rate were measured between the two groups.Results After treatment,the levels of SjvO2 and CjvO2 in treatment group were(65.46±7.72)×10^-2,(114.58±9.81)mL·L^-1,had significant difference with those in control gorup,which were(55.31±6.03)×10^-2,(99.16±8.47)mL·L^-1(P<0.05).After treatment,the levels of FIB in treatment group and control group were(2.04±0.26),(2.48±0.51)g·L^-1,TG were(2.05±0.26),(2.61±0.23)mmol·L^-1,with significant difference(P<0.05).After treatment,the NSE,GFAP,S-100 B,CIMT and plaque area in treatment group were(7.71±1.76)μg·L^-1,(0.88±0.42)ng·L^-1,(0.52±0.14)μg·L^-1,(0.78±0.22)mm,(19.08±4.15)mm^2,all had significant difference with those in control gorup,which were(9.68±2.13)μg·L^-1,(1.35±0.31)ng·L^-1,(0.64±0.23)μg·L^-1,(1.47±0.24)mm,(21.86±4.46)mm^2(all P<0.05).The recurrence rates in3,6 and 9 months after treatment in treatment group were lower than those in control group(P<0.05).During the treatment,the incidence of adverse drug reactions between the two groups had no significant difference(P>0.05).Conclusion Butylphthalide sequential therapy combined with ozagrel sodium is

关 键 词：丁苯酞序贯疗法 奥扎格雷钠 短暂性脑缺血发作 神经功能 脑氧代谢 

分 类 号：R971[医药卫生—药品]