丁苯酞与依达拉奉结合治疗中青年缺血性脑小血管病的效果及对脑血流、炎症小体NLRP3有关炎性因子表达的影响  

The effect of the combination of butylphthalide and edaravone in the treatment of ischemic small vascular disease in middle-aged and young patients and its effect on cerebral blood flow and the expression of related inflammatory factors in inflammasome NLRP3

作　　者：宋璞[1] 张青山[1] 孙慧勤[1] 赵莉[1] 王倩楠 SONG Pu;ZHANG Qingshan;SUN Huiqin;ZHAO Li;WANG Qiannan(Xuzhou Central Hospital,Xuzhou Jiangsu 221000,China)

机构地区：[1]徐州市中心医院,江苏徐州221000

出　　处：《中国急救复苏与灾害医学杂志》2022年第3期339-343,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：江苏省优势学科建设工程项目(编号:YSHL0803-111)。

摘　　要：目的探讨丁苯酞与依达拉奉结合治疗中青年缺血性脑小血管病(SVD)疗效及对脑血流、炎症小体核苷酸结合寡聚化结构域样受体家族含pyrin结构域蛋白3(NLRP3)有关炎性因子水平的干预效果。方法选取2017年6月—2019年6月徐州市中心医院中青年缺血性SVD患者62例,以简单随机化法分为观察组(n=31)、对照组(n=31)。常规基础上,对照组给予依达拉奉,观察组给予丁苯酞结合依达拉奉,均治疗2周。比较两组疗效、不良反应发生率及治疗前、治疗1周、2周后神经功能缺损程度评分(NIHSS)、认知功能评分(MoCA)、日常生活能力评分(BI)、脑血流参数[脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)]、血管内皮功能指标[血管性血友病因子(vWF)、一氧化氮(NO)、内皮素-1(ET-1)]、炎症小体NLRP3有关炎性因子[白细胞介素-18(IL-18)、白细胞介素-1β(IL-1β)]水平。结果观察组治疗2周后总有效率较对照组高(P<0.05);观察组治疗1周、2周后NIHSS评分低于对照组,MoCA、BI评分高于对照组(P<0.05);观察组治疗1周、2周后CBV、CBF水平高于对照组,MTT水平低于对照组(P<0.05);观察组治疗1周、2周后血清vWF、ET-1、IL-18、IL-1β水平低于对照组,NO水平高于对照组(P<0.05);两组治疗期间不良反应发生率相比,差异无统计学意义(P>0.05)。结论对中青年缺血性SVD患者予以丁苯酞联合依达拉奉治疗,可有效增加患者脑血流,改善脑血管储备功能及血管内皮功能,促进患者神经功能、认知功能、日常生活活动能力恢复,效果较为显著。Objective To investigate the therapeutic effect of the combination of butylphthalide and edaravone in the treatment of ischemic small vascular disease(SVD)in middle-aged and young patients and the effect of intervention on cerebral blood flow,NOD-like receptor family,pyrin domaincontaining protein 3(NLRP3)related inflammatory factors.Methods A total of 62 middle-aged and young patients with ischemic SVD in our hospital from June 2017 to June 2019 were selected and divided into observation group(n=31)and control group(n=31)by simple randomization method.On the basis of conventional treatment,the control group was given edaravone,and the observation group was given butylphthalide combined with edaravone,both were treated for 2 weeks.The efficacy,incidence of adverse reactions and neurological impairment score(NIHSS),cognitive function score(MoCA),and barthel index score(BI),cerebral blood flow parameters[cerebral blood volume(CBV),cerebral blood flow(CBF),mean transit time(MTT)],vascular endothelial function indexes[von Willebrand factor(vWF),nitric oxide(NO),endothelin-1(ET-1)],the levels of inflammatory factors related to the inflammasome NLRP3[interleukin-18(IL-18)and interleukin-1β(IL-1β)]before treatment,1 week and 2 weeks after treatment were compared between the two groups.Results The total effective rate of the observation group after 2 weeks of treatment was higher than that of the control group(P<0.05).The NIHSS scores of the observation group were lower than those of the control group after 1 week and 2 weeks of treatment,and the MoCA and BI scores were higher than those of the control group(P<0.05).The CBV and CBF levels of the observation group were higher than those of the control group after 1 week and 2 weeks of treatment,and the MTT level was lower than that of the control group(P<0.05).Serum vWF,ET-1,IL-18 and IL-1βlevels in the observation group were lower than those in the control group after 1 week and 2 weeks of treatment,and the NO level was higher than that in the control group(P<0.05).Th

关 键 词：缺血性脑小血管病 丁苯酞 依达拉奉 脑血流 血管储备功能 炎症小体NLRP3 

分 类 号：R743[医药卫生—神经病学与精神病学]