丁苯酞联合阿托伐他汀钙治疗老年人急性脑梗死的疗效观察及对神经功能、氧化应激反应的影响  

Effect of butylphthalide combined with atorvastatin calcium in the treatment of older adult patients with acute cerebral infarction and its influence on neurological function and oxidative stress

作　　者：陈淑华 钱铭净[2] Chen Shuhua;Qian Mingjing(Department of Pharmacy,the First People's Hospital of Huzhou,Huzhou 313000,Zhejiang Province,China;Department of Neurology,the First People's Hospital of Huzhou,Huzhou 313000,Zhejiang Province,China)

机构地区：[1]湖州市第一人民医院药剂科,浙江省313000 [2]湖州市第一人民医院神经内科,浙江省313000

出　　处：《中国基层医药》2021年第2期267-271,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨丁苯酞联合阿托伐他汀钙治疗老年人急性脑梗死的疗效及对患者神经功能、氧化应激反应的影响。方法选择湖州市第一人民医院2019年1-12月收治的老年急性脑梗死患者120例(有溶栓、取栓治疗禁忌证者),按照随机数字表法分为联合组和对照组各60例。在常规治疗(非溶栓、取栓疗法)的基础上,对照组采用阿托伐他汀钙治疗,联合组给予阿托伐他汀钙联合丁苯酞软胶囊治疗。两组疗程均为2周。比较两组治疗疗效,治疗前、治疗后1周和治疗后2周神经功能缺损程度(NIHSS)评分和Barthel指数评定量表(BI)评分及治疗前和治疗后2周氧化应激指标[丙二醛(MDA)、谷胱甘肽超氧化物酶(GSH-Px)和超氧化物歧化酶(SOD)]的变化。结果联合组总有效率(93.33%)高于对照组(70.00%)(χ^(2)=10.909,P<0.05);联合组治疗后1周、治疗后2周NIHSS评分分别为(7.83±0.67)分、(5.32±0.51)分,均低于对照组的(9.71±0.82)分、(7.18±0.63)分(t=13.752、17.775,均P<0.05);联合组治疗后1周、治疗后2周BI评分分别为(54.37±3.18)分、(70.29±5.45)分,均高于对照组的(46.73±3.89)分、(59.83±6.38)分(t=8.329、9.656,均P<0.05);联合组治疗后2周血清MDA(4.27±0.85)nmol/L,低于对照组的(6.73±1.20)nmol/L,而GSH-Px[(89.94±5.36)U/L]和SOD[(263.13±16.52)IU/L],高于对照组的(76.83±4.61)U/L和(189.91±10.36)IU/L,两组差异均有统计学意义(t=12.958、14.364、29.086,均P<0.05)。结论丁苯酞联合阿托伐他汀钙治疗老年人急性脑梗死疗效良好,可改善患者神经功能,及减轻氧化应激损伤。Objective To investigate the effect of butylphthalide combined with atorvastatin calcium in the treatment of elderly patients with acute cerebral infarction and its influence on neurological function and oxidative stress reaction.Methods A total of 120 older adult patients with acute cerebral infarction(with contraindications of thrombolysis and thrombectomy)who received treatment in the First People's Hospital of Huzhou during January to December 2019 were included in this study.They were randomly assigned to receive treatment with atorvastatin calcium(control group,n=60)or butylphthalide combined with atorvastatin calcium(combined treatment group,n=60)for 2 weeks based on conventional non-thrombolysis and non-thrombectomy treatment.The therapeutic effect was compared between the control and the combined treatment groups.The National Institutes of Health Stroke Scale score and the Barthel Index before and 1 and 2 weeks after treatment,and serum levels of oxidative stress markers malondialdehyde(MDA),glutathione peroxidase(GSH-Px)and superoxide dismutase(SOD)before and 2 weeks after treatment were measured.Results Total effective rate in the combined treatment group was significantly higher than that in the control group(93.33%vs.70.00%,χ^(2)=10.909,P<0.05).At 1 and 2 weeks after treatment,the National Institutes of Health Stroke Scale score in the combined treatment group was(7.83±0.67)points and(5.32±0.51)points,respectively,which was significantly lower than(9.71±0.82)points and(7.18±0.63)points,respectively in the control group(t=13.752,17.775,both P<0.05).At 1 and 2 weeks after treatment,the Barthel Index in the combined treatment group was 54.37±3.18 and 70.29±5.45 respectively,which was significantly higher than 46.73±3.89 and 59.83±6.38,respectively in the control group(t=8.329,9.656,both P<0.05).At 2 weeks after treatment,serum level of malondialdehyde in the combined treatment group was significantly lower than that in the control group[(4.27±0.85)nmol/L vs.(6.73±1.20)nmol/L].Serum levels of

关 键 词：脑梗死 丙二醛 超氧化物歧化酶 神经功能 丁苯酞 阿托伐他汀钙 老年人 

分 类 号：R743.33[医药卫生—神经病学与精神病学]