丁苯肽软胶囊对脑梗死伴认知功能障碍患者血清MMP-9及TIMP-1水平、神经及认知功能的影响  

Effects of butyphthalide on serum MMP-9 level,TIMP-1 level,neurological function,and cognitive function in patients with cerebral infarction accompanied by cognitive impairment

作　　者：陈德艳[1] 周慧[1] 戎天艺 CHEN De-yan;ZHOU Hui;RONG Tian-yi(Department of Neurology,Shanghai Yangpu Shidong Hospital,Shanghai 200438,CHINA)

机构地区：[1]上海市杨浦区市东医院神经内科,上海200438

出　　处：《海南医学》2020年第22期2876-2879,共4页Hainan Medical Journal

基　　金：2017年上海市卫生和计划生育委员会科研课题计划项目(编号:2017450)。

摘　　要：目的探讨丁苯肽软胶囊对脑梗死伴认知功能障碍患者血清基质金属蛋白酶-9(MMP-9)和基质金属蛋白酶抑制剂-1(TIMP-1)水平、神经及认知功能的影响。方法选择2016年1月至2019年4月在上海市杨浦区市东医院神经科住院治疗的脑梗死伴认知功能障碍患者72例,采用随机数表法分为对照组和观察组各36例。对照组患者酌情给予控制颅内压、血压、血糖及血脂,抑制血小板聚集,营养神经保护和改善微循环等基础治疗。观察组在此基础上口服丁苯酞软胶囊0.2 g/次,3次/d。两组患者疗程均4周。评估两组患者治疗前后的血清MMP-9及TIMP-1水平、神经功能指标[神经功能缺损(NFD)评分]和认知功能指标[韦氏记忆量表(WMS)评分和蒙特利尔认知评估量表(MoCA)评分]的变化,并比较不良反应发生率。结果治疗4周后,两组患者的血清MMP-9水平均较治疗前明显下降,而TIMP-1水平均较治疗前明显上升,且观察组下降或上升幅度较对照组更明显,差异均有统计学意义(P<0.05);同时两组患者的NFD评分较治疗前均明显下降,而WMS评分及MoCA评分较治疗前明显上升,且观察组下降或上升幅度较对照组更明显,差异均有统计学意义(P<0.05);对照组与观察组治疗期间分别出现不良反应3例(8.33%)和5例(13.89%),症状均较轻,两组患者的不良反应发生率比较差异无统计学意义(P>0.05)。结论丁苯肽软胶囊治疗脑梗死伴认知功能障碍可改善患者的神经及认知功能,安全性较好,其作用机制可能与其能抑制MMP-9分泌,促进血清TIMP-1释放,纠正体内MMP-9/TIMP-1比值失调密切相关。Objective To investigate the effects of butyphthalide on serum matrix metalloproteinase(MMP-9)level,tissue inhibitor of metalloproteinase-1(TIMP-1)level,neurological function,and cognitive function in patients with cerebral infarction accompanied by cognitive impairment.Methods Seventy-two patients with cerebral infarction accompanied by cognitive impairment treated in Department of Neurology,Shanghai Yangpu Shidong Hospital from January 2016 to April 2019 were randomly divided into two groups by random number table,with 36 patients in each group.The patients in control group were given basic treatments such as controlling intracranial pressure,blood pressure,blood glucose,blood lipids,inhibiting platelet aggregation,nutritional protection,and improving microcirculation as appropriate.The patients in observation group were furthermore given orally butylphthalide soft capsule 0.2 g/time,3 times/d.The patients in two groups were treated for 4 weeks.The changes of serum MMP-9 and TIMP-1 levels,neurological function indexes(Nerve Function Defect[NFD]scores),and cognitive function indexes(Wechsler Memory Scale[WMS]scores and Montreal Cognitive Assessment[MoCA]scores)before and after treatment were evaluated in two groups,and the incidences of adverse reactions were compared.Results After 4 weeks'treatment,the serum MMP-9 levels in two groups were decreased significantly and TIMP-1 levels were significantly increased compared with those before treatment,and the decline or increase in observation group was more significant than that in control group(P<0.05);the NFD scores in two groups were significantly decreased than before,while the WMS scores and MoCA scores were significantly increased than before,and the decline or increase in observation group was more significant than that in control group(P<0.05).There were 3(8.33%)and 5(13.89%)cases of adverse reactions separately in control group and observation group during treatment,and the symptoms were mild.There was no significant difference in the incidence of adverse r

关 键 词：脑梗死 认知功能障碍 丁苯肽 基质金属蛋白酶-9 基质金属蛋白酶抑制剂-1 

分 类 号：R743.33[医药卫生—神经病学与精神病学]