双联抗血小板联合丁苯酞治疗对进展性脑梗死患者血清炎症因子水平及神经功能评分的影响  

Effect of dual antiplatelet combined with butylphthalide on serum inflammatory factor levels and neurological function scores in patients with progressive cerebral infarction

作　　者：林凯胜[1] 林哲聪[1] 林东[1] 吴燕[1] 黄晓新[1] 韩巧琳[1] LIN Kaisheng;LIN Zhecong;LIN Dong;WU Yan;HUANG Xiaoxin;HAN Qiaolin(Department of Neurology,Jieyang People's Hospital,Jieyang 522000,Guangdong,China)

机构地区：[1]广东省揭阳市人民医院神经内科,广东揭阳522000

出　　处：《右江医学》2020年第8期596-601,共6页Chinese Youjiang Medical Journal

基　　金：揭阳市科技计划项目(2018wsyl029)。

摘　　要：目的探究进展性脑梗死(progressive cerebral infarction,PCI)患者经双联抗血小板联合丁苯酞注射液治疗的临床效果及对血清炎症因子和神经功能的影响。方法选取2018年9月到2019年6月期间收治的进展性脑梗死患者106例为研究对象,采用随机双盲法分为常规组及研究组(每组53例)。患者入院后均给予常规治疗以及双联抗血小板(阿司匹林肠溶片+硫酸氢氯吡格雷片)治疗,在此基础上研究组联合丁苯酞注射液治疗,共治疗8周。比较两组患者治疗总有效率,治疗前后两组患者血清炎症因子水平、β-淀粉样蛋白(amyloidβ-protein42,Aβ42)、神经元特异性烯醇化酶(neuron-specific enolase,NSE)水平以及美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)、Barthel指数和改良Rankin量表(modified Rankin scale,MRS)评分。结果研究组治疗总有效率(90.57%)明显高于常规组(73.58%),比较差异有统计学意义(χ2=5.194,P=0.023);治疗8周后,两组患者血清TNF-α、IL-6、Aβ42及NSE水平均较治疗前明显降低,且研究组患者各项指标水平低于常规组,差异有统计学意义(P<0.001);研究组NIHSS、MRS评分均较常规组有所下降,Barthel指数评分较常规组有所上升,差异有统计学意义(P<0.01或0.001)。结论双联抗血小板联合丁苯酞注射液可显著提高进展性脑梗死患者临床治疗效果,显著改善其血清炎症因子水平,有效抑制氧化应激及炎症反应,显著改善患者神经功能,值得在临床推广使用。Objective To investigate the effect of dual antiplatelet combined with butylphthalide in the treatment of progressive cerebral infarction(PCI) and its influence on serum inflammatory factors and nerve function.Methods 106 patients with PCI admitted to hospital from September 2018 to June 2019 were selected as research objects and divided into conventional group and observation group by random double-blind method,with 53 cases in each group.After admission,both groups were given conventional treatment and dual antiplatelet(aspirin enteric-coated tablets+clopidogrel bisulfate tablets) treatment.On this basis,the observation group were treated with butylphthalide injection for 8 weeks.And then,the total effective rates of treatment in the two groups were compared.The levels of serum inflammatory factors,amyloid β-protein42(Aβ42) and Neuron-Specific Enolase(NSE),the National Institute of Health Stroke Scale(NIHSS),Barthel index,and Modified Rankin Scale(MRS) scores before and after treatment were compared between the two groups.Results The total effective rate of treatment in the observation group(90.57%) was significantly higher than that in the conventional group(73.58%),and difference was statistically significant(χ2=5.194,P=0.023).After 8 weeks of treatment,serum TNF-α,IL-6,Aβ42 and NSE levels of both groups were significantly lower than those before treatment,and those of the observation group were lower than those of the conventional group,and difference was statistically significant(P<0.001).The NIHSS and MRS scores of the observation group decreased compared with those of the conventional group,and the Barthel index score increased compared with the conventional group,and difference was statistically significant(P<0.01 or 0.001).Conclusion Dual antiplatelet combined with butylphthalide injection can significantly improve the clinical treatment effect of patients with progressive cerebral infarction,significantly improve their serum inflammatory factor levels,effectively inhibit oxidative stresses and inf

关 键 词：双联抗血小板 丁苯酞 进展性脑梗死 炎症因子 神经功能 

分 类 号：R743.33[医药卫生—神经病学与精神病学]