丁苯酞与巴曲酶对END脑梗死患者血浆炎症因子及神经功能的影响  

Effects of Butylphthalide and Batroxobin on Plasma Inflammatory Factors and Neurological Function in Cerebral Infarction Patients with END

作　　者：欧阳和中[1] 王岩[1] 潘生英 OUYANG Hezhong;WANG Yan;PAN Shengying(Danyang People's Hospital,Zhenjiang,Jiangsu 212300,China)

机构地区：[1]丹阳市人民医院,江苏镇江212300

出　　处：《大医生》2020年第18期88-91,共4页Doctor

基　　金：镇江市社会发展指导性项目(编号:FZ201903)。

摘　　要：目的研究丁苯酞注射液与巴曲酶对早期神经功能恶化的分水岭性脑梗死患者血浆脂蛋白磷脂酶a2(Lp-PLA2)、C反应蛋白(CRP)、神经元特异性烯醇化酶(NSE)等因子及神经功能的不同影响。方法选取丹阳市人民医院2019年1月至2020年3月收治的122例入院72 h内发生早期神经功能恶化(Early Neurological Deterioration,END)的分水岭性脑梗死患者为研究对象,采用随机数字表法分为丁苯酞组(61例)与巴曲酶组(61例),比较两组患者入院时和出院时的血浆Lp-PLA2、NSE、CRP水平,比较入院时、发生END时、出院时以及出院90 d时美国国立卫生研究院卒中量表(NIHSS)评分、改良的Rankin评分(mRS),比较END时、出院时及出院90 d时两组简易智力状态检查量表(MMSE)评分。结果治疗前两组患者的NIHSS评分、血浆Lp-PLA2、NSE、CRP水平均差异无统计学意义(P>0.05),而治疗后两组的NSE、CRP、Lp-PLA2、NIHSS评分均有下降,且丁苯酞组的炎症因子Lp-PLA2水平下降更显著(P<0.05),而巴曲酶组NSE、NIHSS评分显著低于丁苯酞组。两组患者90 d的mRS评分差异无统计学意义(P>0.05),但丁苯酞组的MMSE评分高于巴曲酶组,相关性分析显示出院时Lp-PLA2水平与3个月时的MMSE评分成负相关(P<0.05)。结论巴曲酶能更为快速地终止END,减轻神经功能损害;而丁苯酞可更有效地减轻梗死后的炎症反应,更好地改善卒中后的认知功能。Objective To study the effects of butylphthalide and batroxobin on plasma Lp-PLA2,CRP,NSE and other factors and neurological function in patients with watershed cerebral infarction.Methods Selection of Danyang People's Hospital from January 2019 to March 2020,122 cases of hospital occurred within 72 h of early neurologic deterioration(Early Neurological Deterioration,END)of the watershed cerebral infarction patients as the research object,using the random number table method divided into butyl phthalide group(61 cases)and the enzyme group(61 cases),compare the two groups of patients on admission and discharge plasma Lp-PLA2,NSE,CRP levels,The National Institutes of Health Stroke Scale(NIHSS)scores and the modified Rankin Scale(mRS)scores were compared at admission,at the onset of END,at discharge and at 90 d after discharge.The MMSE scores were compared at the END,at discharge and at 90 d after discharge.Results There was no significant difference in baseline NIHSS score,MMSE score,plasma Lp-PLA2,NSE and CRP levels between the two groups(P>0.05),but NSE,CRP,Lp-PLA2 and NIHSS scores of the two groups were decreased after treatment,and the level of inflammatory factor Lp-PLA2 in butylphthalide group decreased more significantly(P<0.05),NSE and NIHSS scores of batroxobin group were significantly lower than those of butylphthalide group.There was no significant difference in mRS scores between the two groups at 90 days(P>0.05).The MMSE score of butylphthalide group was higher than that of batroxobin group.The correlation analysis showed that there was a negative correlation between Lp-PLA2 level at discharge and MMSE score at 90 days(P<0.05).Conclusion Batroxobin can terminate early neurological deterioration more quickly and reduce neurological impairment;butylphthalide can more effectively reduce the inflammatory reaction and improve the cognitive function after stroke.

关 键 词：早期神经功能恶化 分水岭脑梗死 脂蛋白磷脂酶A2 神经元特异性烯醇化酶 认知功能 

分 类 号：R74[医药卫生—神经病学与精神病学]