丁苯酞应用于rt-PA静脉溶栓脑卒中的疗效性和安全性分析  

Efficacy and safety of butylphthalide combined with rt-Pa injection on patients with acute cerebral infarction

作　　者：侯晓君 田春博 潘成利[1] 黄月萍[1] 王喜春[1] HOU Xiaojun;TIAN Chunbo;PAN Chengli(Department of Neurology,HeilongJiang Provincial Hospital,Harbin 150036,China)

机构地区：[1]黑龙江省医院老年神经内科,黑龙江哈尔滨150036

出　　处：《中风与神经疾病杂志》2020年第8期716-719,共4页Journal of Apoplexy and Nervous Diseases

基　　金：黑龙江省卫生健康委科研课题(No.2019-170)。

摘　　要：目的分析丁苯酞注射液应用于rt-PA静脉溶栓脑卒中的疗效和安全性。方法根据rt-PA静脉溶栓的急性缺血性脑卒中(AIS)患者是否接受丁苯酞注射液治疗分成rt-PA静脉溶栓+丁苯酞注射液治疗组(n=124)和rt-PA静脉溶栓+0.9%生理盐水对照组(n=75)。对两组基线资料及治疗后24 h、7 d、14 d美国国立卫生研究院卒中量表(NIHSS)评分、颅内多普勒超声(TCD)监测大脑中动脉平均血流速度(Vm)及搏动指数(PI)、基质金属蛋白酶9(MMP-9)、90 d mRS评分等临床指标进行比较及分析。结果治疗组NIHSS评分、MMP-9明显低于对照组(P<0.05);TCD监测Vm、PI,治疗组均明显高于对照组(P<0.05)。mRS评分治疗组的预后良好率为93.0%,差异有统计学意义(P<0.05)。结论rt-PA静脉溶栓患者应用丁苯酞注射液有显著临床疗效,未增加不良反应发生率及病死率,其作用机制可能与降低血清中MMP-9水平有关。Objective To analyze the efficacy,safety and pharmacological mechanism of butylphthalide in patients with rt-PA intravenous thrombolytic stroke.Methods Patients were divided into rt-PA+butylphthalide injection treatment group(n=124)and rt-PA+0.9%normal saline control group(n=75).We compared the baseline and clinical parameters such as the National Institute of Health stroke scale(NIHSS)score,Transcranial Dopple monitor mean flow velocity(Vm)and Pulse Index(PI)of the middle cerebral artery and serum levels of Matrix metalloprotein-9(MMP-9)at 24 hours,7 days,and 14 days after treatment between the two groups.Modified Rankin Scale(mRS)scores were compared between the two groups after ninety-days of treatment.Results The NIHSS score and MMP-9 in the treatment group were significantly lower than those in the control group(P<0.05);the Vm and PI of the middle cerebral artery in the treatment group were significantly higher than those in the control group(P<0.05).The mRS score in the treatment group was 93.0%,and the difference was statistically significant(P<0.05).Conclusion Butyphthalide combined with alteplase helps to improve the clinical efficacy and prognosis of patients without increasing the incidence and mortality of adverse reactions and its mechanism may be related to the reduction of MMP-9 level in serum.

关 键 词：丁苯酞注射液 RT-PA 基质金属蛋白酶9(MMP-9) 疗效 

分 类 号：R743.3[医药卫生—神经病学与精神病学]