丁苯酞氯化钠注射液联合经颅磁刺激对急性脑梗死后血管性认知功能障碍的影响及机制研究  

Effects of butylphthalide sodium chloride injection combined with transcranial magnetic stimulation on the vascular endothelial function and oxidative stress injury in patients with vascular cognitive impairment after acute cerebral infarction

作　　者：王军英[1] 段毅[1] 赵平平[1] 王坤[1] 张云书[1] 高瑞利[1] 张莉[1] WANG Junying;DUAN Yi;ZHAO Pingping(Department of Neurology,The Third Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050011,China)

机构地区：[1]河北省石家庄市第三医院神经内科,050011

出　　处：《河北医药》2020年第22期3459-3461,共3页Hebei Medical Journal

基　　金：石家庄市科技局课题(编号:171792043)。

摘　　要：目的探讨丁苯酞氯化钠注射液联合经颅磁刺激对急性脑梗死后血管性认知功能障碍的影响及其机制。方法急性脑梗死后血管性认知功能障碍患者140例,随机分为联合治疗组和对照组,每组70例,联合治疗组在常规治疗脑梗死药物基础上加用丁苯酞氯化钠注射液联合经颅磁刺激治疗2周,对照组给予常规治疗脑梗死药物。于治疗前后应用简易精神状态检查表(MMSE)和日常生活能力量表(ADL)评估患者认知功能,并观察治疗后患者血清内皮素(ET)-1、一氧化氮(NO)、丙二醛(MDA)和过氧化氢(H2O2)含量,超氧化物歧化酶(SOD)和过氧化氢酶(CAT)活性。结果与治疗前比较,2组患者治疗后MMSE和ADL评分均明显改善,且联合治疗组MMSE评分高于对照组,ADL评分也高于对照组,差异均有统计学意义(P<0.05)。与对照组比较,联合治疗组ET-1、MDA和H2O2含量明显下降,SOD和CAT活性及NO含量明显升高,差异均有统计学意义(P<0.05)。结论丁苯酞氯化钠注射液联合经颅磁刺激治疗可有效降低急性脑梗死后血管性认知功能障碍患者的氧化应激损伤,进而减轻血管内皮功能受损,从而提高患者的认知功能。Objective To investigate the effects of butylphthalide sodium chloride injection combined with transcranial magnetic stimulation on the vascular endothelial function and oxidative stress injury in patients with vascular cognitive impairment(VCI)after acute cerebral infarction.Methods A total of 140 patients with VCI after acute cerebral infarction who were treated in our hospital from June 2018 to June 2019 were enrolled in the study,who were randomly divided into combination treatment group and control group,with 70 cases in each group.The patients in combination treatment group were treated by butylphthalide sodium chloride injection combined with transcranial magnetic stimulation for two weeks,however,the patients in control group were treated by conventional treatment drugs for cerebral infarction.The patients’cognitive function was evaluated by the Mini-mental state examination(MMSE)and the Lawton Activities of Daily Living(ADL)before and after treatment.Moreover the changes of serum levels of ET-1,NO,MDA,H2O2,and SOD activity as well as CAT activity were observed and compared between the two groups.Results As comparedwith those before treatment,the MMSE and ADL scores in both groups were obviously improved after treatment,moreover,the MMSE scores and ADL scores in combination treatment group were significantly higher than those in control group(P<0.05).As compared with those in control group,the levels of ET-1,MDA,and H2O2 in combination treatment group were significantly decreased(P<0.05),however,the levels of NO and SOD and the activities of SOD and CAT were significantly increased(P<0.05).Conclusion The butylphthalide sodium chloride injection combined with transcranial magnetic stimulation can effectively reduce the oxidative stress injury in patients with vascular cognitive dysfunction after acute cerebral infarction,so as to improve vascular endothelial function and improve cognitive function of patients.

关 键 词：急性脑梗死 血管性认知障碍 丁苯酞 经颅磁刺激 氧化应激损伤 

分 类 号：R743[医药卫生—神经病学与精神病学]