中风Ⅱ号方对急性脑梗死患者血管内皮损伤及炎症反应的影响  

Effects of StrokeⅡcompound prescription on vascular endothelial injury and inflammatory reaction in patients with acute cerebral ischemic infarction

作　　者：佘颜 龙须 邓常清 刘新春[2] She Yan;Long Xu;Deng Changqing;Liu Xinchun(Laboratory of Vascular Biology,School of Medicine,Hunan University of Chinese Medicine,Changsha 410208,Hunan,China;Department of Neurology,The First Affiliated Hospital of Hunan Traditional Chinese Medicine College,Zhuzhou 412000,Hunan,China)

机构地区：[1]湖南中医药大学医学院血管生物学实验室,湖南长沙410208 [2]湖南中医药高等专科学校附属第一医院神经内一科,湖南株洲412000

出　　处：《中国中西医结合急救杂志》2021年第6期653-657,共5页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：湖南省中医药科研计划重点项目(201820)。

摘　　要：目的探究中风Ⅱ号方对急性脑梗死(ACI)患者血管内皮功能及炎症反应的影响。方法选择2019年4月至2020年8月湖南中医药高等专科学校附属第一医院神经内一科的100例ACI患者,按照随机数字表法分为对照组和观察组,每组各50例。对照组给予常规治疗,观察组在常规治疗的基础上联用中风Ⅱ号方,两组均在治疗7 d后进行相关指标检测。采用美国国立卫生研究院卒中量表(NIHSS)和功能独立性量表(FIM)评定中风Ⅱ号方对ACI患者的临床疗效。采用酶联免疫吸附试验(ELISA)检测血清内皮素-1(ET-1)、内皮型一氧化氮合酶(eNOS)和基质细胞衍生因子-1(SDF-1)的水平,以评定中风Ⅱ号方对ACI患者血管内皮功能的影响。采用ELISA检测血清白细胞介素(IL-1β、IL-6)、肿瘤坏死因子-α(TNF-α)、可溶性细胞间黏附分子-1(sICAM-1)、正五聚体蛋白3(PTX3)的水平,以评定中风Ⅱ号方对ACI患者炎症反应的影响。进一步将观察组临床疗效、血管内皮因子及炎性因子之间进行相关性分析。结果治疗后观察组总有效率显著高于对照组〔98.0%(49/50)比88.0%(44/50),P<0.01〕。观察组治疗后血清eNOS和SDF-1含量均高于对照组〔eNOS(μg/L):69.35±4.28比53.57±5.95,SDF-1(ng/L):4099.23±368.45比3964.34±326.96,均P<0.05〕;但血清ET-1、IL-1β、IL-6、TNF-α、sICAM-1和PTX3含量均低于对照组〔ET-1(ng/L):79.78±7.85比101.97±10.22,IL-1β(ng/L):5.86±2.25比10.22±3.63,IL-6(ng/L):2.86±0.88比7.33±3.02,TNF-α(ng/L):19.58±3.68比21.42±4.62,sICAM-1(ng/L):4.28±1.23比5.38±3.65,PTX3(ng/L):12.51±2.79比15.25±2.99,均P<0.05〕。相关性分析表明,观察组治疗前后血管内皮因子、炎性因子与临床疗效之间具有显著关联性。观察组治疗前后血清ET-1含量与NIHSS评分呈正相关(r=0.348,P<0.01);与FIM评分呈负相关(r=-0.501,P<0.01)。血清eNOS、SDF-1含量与NIHSS评分呈负相关(r值分别为-0.378、-0.328,均P<0.01);与FIM评分呈正相关(r�Objective To observe the effect of"StrokeⅡ"compound prescription on vascular endothelial function and inflammatory reaction in patients with acute cerebral ischemic(ACI).Methods One hundred patients with ACI admitted to the department of neurology of the First Affiliated Hospital of Hunan Traditional Chinese Medicine College from April 2019 to August 2020 were enrolled in this study.According to the random number table method,the patients were divided into a control group and an observation group,with 50 cases in each group.The control group was given conventional treatment,while the observation group was given"StrokeⅡ"compound on the basis of conventional treatment.After treatment for 7 days,then various indicators related to the disease were detected in the two groups.The American National Institute of Health Stroke Scale(NIHSS)and functional independent measure(FIM)were used to evaluate the clinical efficacy of"StrokeⅡ"compound for treatment of patients with ACI.The levels of serum endothelin-1(ET-1),endothelial nitric oxide synthase(eNOS)and stromal cell derived factor-1(SDF-1)were detected by enzyme linked immunosorbent assay(ELISA)to evaluate the effect of"StrokeⅡ"compound prescription on vascular endothelial function in patients with ACI.The levels of serum interleukins(IL-1β,IL-6),tumor necrosis factor-α(TNF-α),soluble intercellular adhesion molecule-1(sICAM-1)and pentamer protein(PTX3)were examined by ELISA to evaluate the effect of"StrokeⅡ"compound on inflammatory reaction in patients with ACI.Furthermore,the correlation analyses were performed among the clinical efficacy,vascular endothelial factors,and the inflammatory factors respectively of observation group.Results After treatment,the total effective rate of observation group was significantly higher than that of control group[98.0%(49/50)vs.88.0%(44/50),P<0.01].After treatment,the contents of eNOS and SDF-1 in serum of observation group were higher than those of control group[eNOS(μg/L):69.35±4.28 vs.53.57±5.95,SDF-1(ng/L):4099.23�

关 键 词：中风Ⅱ号方 脑梗死 血管内皮 炎性因子 临床研究 

分 类 号：R74[医药卫生—神经病学与精神病学]