丁苯酞注射液联合氯吡格雷治疗急性大面积脑梗死疗效及对脑血液动力学、功能恢复及血清学指标的影响  

The curative efficacy of butylphthalide injection combined with clopidogrel in the treatment of acute MCI and its effects on cerebral hemodynamics,function recovery and levels of serum indexes

作　　者：孙飞 王久琴 王维 向泊羽 张千江 蔡若蓓 SUN Fei;WANG Jiu-qin;WANG Wei;XIANG Bo-yu;ZHANG Qian-jiang;CAI Ruo-bei(Emergency Department,Guangyuan First People's Hospital,Guangyuan 628017,China;Clinical Laboratory,Yan'an People's Hospital,Yan'an 716000,China)

机构地区：[1]四川省广元市第一人民医院急诊科,四川广元628017 [2]陕西省延安市人民医院检验科,陕西延安716000

出　　处：《实用医院临床杂志》2020年第6期220-223,共4页Practical Journal of Clinical Medicine

摘　　要：目的观察丁苯酞(NBP)注射液联合氯吡格雷(Clo)治疗急性大面积脑梗死(MCI)疗效及对脑血流动力学、神经功能与日常活动能力恢复、血清基质金属蛋白酶-9(MMP-9)、超敏C反应蛋白(hs-CRP)、神经元特异性烯醇化酶(NSE)水平的影响。方法按随机数表法将78例急性MCI患者分为NBP+Clo组(联合组)和Clo组各39例。治疗14 d后评估疗效;于治疗前、治疗14 d后检测患者大脑前动脉(ACA)、中动脉(MCA)、后动脉(PCA)平均血流速度(Vm),评估患者神经功能和日常活动能力,比较两组治疗前后血清学指标水平差异,观察不良反应情况。结果联合组总有效率高于Clo组(P<0.05)。治疗14 d后,两组ACA、MCA、PCA的Vm及改良Barthel指数评定量表(MBI)评分均较治疗前升高,且联合组高于Clo组(P<0.05);两组美国国立卫生研究院卒中量表(NIHSS)评分及血清MMP-9、hs-CRP、NSE水平均较治疗前降低,且联合组低于Clo组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论NBP联合Clo治疗急性MCI疗效显著,有助于进一步改善患者脑血流动力学状态和神经功能损伤,减轻炎症反应,且安全性良好,有一定优势。Objective To observe the efficacy of butylphthalide(NBP)injection combined with clopidogrel(Clo)in the treatment of acute massive cerebral infarction(MCI)and its effects on cerebral hemodynamics,recovery of neurological function,daily activity ability and levels of serum matrix metalloproteinase-9(MMP-9),high-sensitivity C-reactive protein(hs-CRP)and neuron-specific enolase(NSE).Methods Seventy-eight patients with acute MCI were divided into NBP+Clo group(combined group)and Clo group according to the random number table method,39 in each group.The efficacy was evaluated after 14 days of treatment.The mean blood flow velocities(Vm)of anterior cerebral artery(ACA),middle cerebral artery(MCA)and posterior cerebral artery(PCA)were measured before treatment and after 14 days of treatment,and the neurological function was assessed by using National Institutes of Health Stroke Scale(NIHSS)and daily activity ability was evaluated by using modified Barthel index(MBI).The levels of serological indicators such as MMP-9,hs-CRP and NSE were compared between the two groups before and after treatment,and the adverse reactions were observed.Results The total effective rate in the combined group was higher than that in the Clo group(P<0.05).After 14 days of treatment,Vm values of ACA,MCA and PCA and MBI score in the two groups were higher than those before treatment,and the indexes in the combined group were higher than those in the Clo group(P<0.05).The NIHSS score and levels of serum MMP-9,hs-CRP and NSE in the two groups were lower than those before treatment,and the indexes in the combined group were lower than those in the Clo group(P<0.05).There was no significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion NBP combined with Clo has significant efficacy on acute MCI,and it is helpful to further improve the cerebral hemodynamics and neurological damage,and reduce the inflammatory response.It has a good safety and certain advantages.

关 键 词：急性大面积脑梗死 丁苯酞 氯吡格雷 脑血液动力学 神经功能 炎症反应 

分 类 号：R743.3[医药卫生—神经病学与精神病学]