双联抗血小板联合丁苯酞序贯疗法治疗超时间窗急性进展性脑梗死的疗效研究  

Study of double antiplatelet combined with butylphthalide sequential therapy in the treatment of acute progressive cerebral infarction beyond time window

作　　者：林凯胜[1] 韩巧琳[1] 彭扬君[1] 杨白杨 林东[1] 陈栎[1] 张展青[1] 黄晓新[1] LIN Kai-sheng;HAN Qiao-lin;PENG Yang-jun(Department of Internal Medicine-Neurology,Jieyang People’s Hospital,Jieyang 522000,China)

机构地区：[1]广东省揭阳市人民医院神经内科,522000

出　　处：《中国实用医药》2020年第17期19-22,共4页China Practical Medicine

基　　金：2018年揭阳市卫生医疗科技创新项目(项目编号:2018wsyl029),项目名称:双联抗血小板联合丁苯酞序贯疗法治疗超时间窗急性进展性脑梗死疗效的临床研究。

摘　　要：目的观察双联抗血小板联合丁苯酞序贯疗法治疗超时间窗急性进展性脑梗死APCI的临床效果。方法103例超时间窗APCI患者,采用随机数字表法将其分为联合组(52例)和单一组(51例)。所有患者入院后均行常规治疗,在此基础上,单一组行双联抗血小板治疗,联合组在单一组基础上行丁苯酞序贯疗法治疗。观察比较两组患者治疗效果、治疗期间不良反应发生率,治疗前后美国国立卫生研究院卒中量表(NIHSS)、日常生活能力量表(ADL)评分及血清神经元特异性烯醇化酶(NSE)、血清同型半胱氨酸(Hcy)水平。结果联合组治疗总有效率为92.31%,明显高于单一组的70.59%,差异有统计学意义(P<0.05)。治疗后,两组NIHSS评分较治疗前有所下降,ADL评分较治疗前有所上升,且联合组NIHSS评分(8.67±2.91)分显著低于单一组的(14.75±3.69)分,ADL评分(88.25±4.11)分显著高于单一组的(68.32±4.03)分,差异具有统计学意义(P<0.05)。治疗后,两组血清NSE、Hcy水平较治疗前下降,且联合组显著低于单一组,差异具有统计学意义(P<0.05)。结论双联抗血小板联合丁苯酞序贯疗法治疗超时间窗APCI患者的临床疗效显著,可改善其神经功能缺损程度,提高日常生活能力,改善血清NSE、Hcy水平,且不良反应少,可供临床参考。Objective To observe the clinical effect of double antiplatelet combined with butylphthalide sequential therapy in the treatment of acute progressive cerebral infarction(APCI)beyond time window.Methods A total of 103 patients with APCI beyond time window were divided into combined group(52 cases)and single group(51 cases)by random numerical table.All patients underwent conventional therapy.On this basis,single group received double antiplatelet therapy,and combined group received butylphthalide sequential therapy on the basis of single group.The therapeutic effect,occurrence of adverse reactions during treatment,National Institutes of Health stroke scale(NIHSS),activities of daily living(ADL)scores and serum neuron-specific enolase(NSE),serum homocysteine(Hcy)levels before and after treatment were observed and compared between the two groups.Results The total effective rate of treatment of the combined group was 92.31%,which was obviously higher than that of single group 70.59%,and the difference was statistically significant(P<0.05).After treatment,NIHSS score of the two groups were lower than those before treatment,and ADL score was higher than those before treatment.NIHSS score(8.67±2.91)points of combined group was significantly lower than that of single group(14.75±3.69)points,and ADL score(88.25±4.11)points was significantly higher than that of single group(68.32±4.03)points,and the difference was statistically significant(P<0.05).After treatment,the levels of serum NSE and Hcy of the two groups were lower than those before treatment,and the combined group was significantly lower than that of single group,and the difference was statistically significant(P<0.05).Conclusion Double antiplatelet combined with butylphthalide sequential therapy shows remarkable clinical efficacy in the treatment of acute progressive cerebral infarction beyond time window,which can improve the degree of nerve function defect,the ability of daily life,the level of serum NSE and Hcy with fewer adverse reactions,which can be used

关 键 词：双联抗血小板 丁苯酞序贯疗法 超时间窗急性进展性脑梗死 

分 类 号：R743.3[医药卫生—神经病学与精神病学]