丁苯酞序贯联合常规用药治疗脑梗死合并颈内动脉中重度狭窄患者的临床研究  

Effect of butylphthalide sequential combined with conventional measures in the treatment of cerebral infarction with moderate to severe internal carotid artery stenosis

作　　者：张剑[1] 刘芳怡[1] 陈源[1] 陈红莲[1] 王明磊 ZHANG Jian;LIU Fang-yi;CHEN Yuan;CHEN Hong-lian;WANG Ming-lei(Department of Medicine,Luohe Medical Vocational School,Luohe 462000,Henan Province,China;Department of Cardiac Rehabilitation,Luohe Medical College First Affiliated Hospital,Luohe First People’s Hospital,Luohe 462000,Henan Province,China)

机构地区：[1]漯河医学高等专科学校医疗系,河南漯河462000 [2]漯河医专第一附属医院、漯河市第一人民医院心脏康复科,河南漯河462000

出　　处：《中国临床药理学杂志》2021年第14期1851-1854,共4页The Chinese Journal of Clinical Pharmacology

基　　金：2019年度河南省重点研发与推广专项(科技攻关)基金资助项目(192102310316);2019年度漯河医学高等专科学校创新创业发展能力提升工程教育教学改革研究基金资助项目(2019-LYZKYYB023)。

摘　　要：目的观察丁苯酞序贯联合常规用药治疗脑梗死合并颈内动脉中、重度狭窄的效果。方法将92例急性脑梗死患者随机分为对照组46例与试验组46例。对照组给予阿司匹林,每次300 mg,qd,口服;阿托伐他汀钙,每次20 mg,qd,口服;依达拉奉30 mL+氯化钠注射液100 mL,bid,静脉滴注。试验组在对照组的基础上,第1~14天给予丁苯酞氯化钠注射液25 mg+氯化钠注射液100 mL,bid,静脉滴注第15~30天给予丁苯酞软胶囊,每次0.1 g,tid,口服。2组均治疗30 d。比较2组的美国国立卫生研究院卒中量表(NIHSS)、日常生活活动能力量表(ADL)、血小板计数(PLT)、纤维蛋白原(FIB)、D-二聚体(D-D)、治疗效果及药物不良反应发生情况。结果治疗后,试验组和对照组的总有效率分别为97.83%(45例/46例)和82.61%(38例/46例),差异有统计学意义(P<0.05)。治疗后,试验组和对照组的NIHSS评分分别为(6.01±1.29)和(8.08±1.38)分,ADL评分分别为(62.37±4.69)和(57.32±4.61)分,PLT分别为(351.17±35.66)×10^(9)/L和(372.68±38.60)×10^(9)/L,FIB分别为(2.23±0.48)和(3.52±0.51)g·L^(-1),D-D分别为(131.38±46.55)和(160.38±63.25)ng·mL^(-1),差异均有统计学意义(均P<0.05)。试验组和对照组在治疗过程中的药物不良反应发生率分别为15.22%和10.87%,差异无统计学意义(P>0.05)。结论在脑梗死合并颈内动脉中、重度狭窄患者的治疗过程中使用丁苯酞序贯联合常规措施,有效提升治疗效果,保护神经功能,安全性良好。Objective To observe the effect of butylphthalide sequential combined with conventional measures in the treatment of cerebral infarction with moderate to severe internal carotid artery stenosis.Methods Ninety-two patients were randomly divided into control group 46 cases and treatment group 46 cases.Control group was given aspirin 300 mg each time,qd orally,atorvastatin calcium 20 mg each time,qd,orally,edaravone 30 mL+sodium chloride injection 100 mL,bid,intravenous drip.Treatment group was given butylphthalide sequential treatment on the basis of control group:d1~d14,butylphthalide sodium chloride injection 25 mg+sodium chloride injection 100 mL,bid,intravenous drip,on d15-d30,butylphthalide soft capsules 0.1 g each time,tid,orally.The treatment time of both groups was 30 d.The National Institutes of Health Stroke Scale(NIHSS),activity of daily living scale(ADL),platelet count(PLT),fibrinogen(FIB),D-dimer(D-D),clinical effects,adverse drug reactions in two groups were compared.Results After treatment,the total clinical efficacy in treatment group and control group were 97.83%(45 cases/46 cases)and 82.61%(38 cases/46 cases),with significant difference(P<0.05).After treatment,the NIHSS in treatment group and control group were(6.01±1.29)and(8.08±1.38)points,ADL scores were(62.37±4.69)and(57.32±4.61)points,PLT were(351.17±35.66)×10^(9)/L and(372.68±38.60)×10^(9)/L,FIB were(2.23±0.48)and(3.52±0.51)g·L^(-1),D-D were(131.38±46.55)and(160.38±63.25)ng·mL^(-1),all with significant difference(all P<0.05).The incidence of adverse drug reactions in treatment group and control group during treatment were 15.22%and 10.87%,without significant difference(P>0.05).Conclusion In the treatment of patients with acute ischemic stroke,the use of butylphthalide injection combined with conventional western medicine can help improve the treatment effect,protect the nerve function,with good safety.

关 键 词：丁苯酞 急性脑梗死 颈内动脉狭窄 

分 类 号：R972[医药卫生—药品]