丁苯酞联合尤瑞克林对分水岭脑梗死急性期患者神经、血管内皮功能及血液流变学的影响  

The effects of butylphthalide combined with Ureklin on nerve and vascular endothelial function and hemorheology in patients with acute cerebral walershecl infarction

作　　者：秦保健 李琳[1] 唐荣盛 张腾 QIN Baojian;LI Lin;TANG Rongsheng;ZHANG Teng(Department of Neurology,Shanxian Central Hospital,Heze Shandong 274300,China)

机构地区：[1]单县中心医院神经内科,山东菏泽274300

出　　处：《中国急救复苏与灾害医学杂志》2022年第3期353-356,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：山东省自然科学基金青年项目(编号:ZR2020QH129)。

摘　　要：目的探讨丁苯酞联合尤瑞克林对分水岭脑梗死急性期(ACWI)患者神经、血管内皮功能及血液流变学的影响。方法选取单县中心医院2018年2月—2020年3月就诊的ACWI患者86例,依照随机数字表法分为两组。对照组患者采用尤瑞克林治疗,治疗组在对照组的基础上采用丁苯酞治疗,持续治疗2周后观察效果。比较两组治疗前后美国国立卫生研究院卒中量表(NIHSS)、血清血管内皮生长因子(VEGF)、内皮素-1(ET-1)、一氧化氮(NO)水平、血液全血低切黏度、血浆黏度以及血细胞比容,比较两组用药期间出血事件及不良反应的发生情况,随访3个月,将改良Rankin量表(mRS)评分≤2分判定为预后良好,统计两组患者预后良好率。结果治疗前,两组患者血细胞比容、NIHSS评分、全血低切黏度、血清VEGF、ET-1、NO水平、血浆黏度比较差异均无统计学意义(P>0.05);两组治疗后的血细胞比容、NIHSS评分、全血低切黏度、血浆黏度均降低(P<0.05),且治疗组更低(P<0.05);治疗后,两组血清NO、VEGF水平均升高(P<0.05),且治疗组更高(P<0.05);随访3个月,对照组失访2例,治疗组失访1例,随访率为95.51%(83/86),治疗组预后良好率(90.48%)比对照组(70.73%)高(P<0.05);用药期间两组出血事件及不良反应发生率对比,差异无统计学意义(P>0.05)。结论丁苯酞联合尤瑞克林治疗ACWI患者,可改善患者的神经、血管内皮功能及预后,调节血液流变学,且安全可靠。Objective To investigate the effects of butylphthalide combined with Urekline on the nerve and vascular endothelial function and hemorheology of patients with acute cerebral walershecl infarction(ACWI).Methods A total of 86 ACWI patients in Shanxian Central Hospital from February 2018 to March 2020 were selected and divided into 2 groups according to the random number table method.Patients in the control group were treated with Ureklin,and the treatment group was treated with butylphthalide on the basis of the control group.The effect was observed after 2 weeks of continuous treatment.The National Institutes of Health Stroke Scale(NIHSS),serum vascular endothelial growth factor(VEGF),endothelin-1(ET-1),nitric oxide(NO)levels,blood whole blood low-shear viscosity,hematocrit andplasma viscositybetween the two groups before and after treatment were compared.The incidence of bleeding events and adverse reactions during the two groups were compared.After 3 months of follow-up,the modified Rankin Scale(mRS)score≤2 points was judged to be a good prognosis,and the good prognosis rate of the two groups was calculated.Results Before treatment,there was no significant difference in hematocrit,NIHSS score,whole blood lowshear viscosity,serum VEGF,ET-1,NO levels,and plasma viscosity between the two groups(P>0.05).After treatment,the hematocrit,NIHSS score,whole blood low-shear viscosity,and plasma viscosity decreased in both groups(P<0.05),and the treatment group was even lower(P<0.05).After treatment,the levels of serum NO and VEGF increased in the two groups(P<0.05),and higher in the treatment group(P<0.05).After 3 months of follow-up,2 cases in the control group were lost to follow-up,and 1 case in the treatment group was lost to follow-up.The follow-up rate was 95.51%(83/86).The good prognosis rate of the treatment group(90.48%)was higher than that of the control group(70.73%)(P<0.05).There was no significant difference in the incidence of bleeding events and adverse reactions between the two groups during medication(P>

关 键 词：丁苯酞 尤瑞克林 分水岭脑梗死急性期 神经功能 血管内皮功能 血液流变学 预后 安全性 

分 类 号：R741[医药卫生—神经病学与精神病学]