丁苯酞序贯联合静脉溶栓对急性脑梗死患者sdLDL-C Annexin A2 Hcy及预后的影响  

Effects of Sequential Butylphthalide Combined with Intravenous Thrombolysis on sdLDL-C Annexin A2,Hcy and Prognosis in Patients with Acute Cerebral Infarction

作　　者：吴云虹[1] 周辉[1] 陈薇 林雅明 WU Yunhong;ZHOU Hui;CHEN Wei(Sanya People's Hospital, Hainan Sanya 572000, China)

机构地区：[1]海南省三亚市人民医院神经内科,海南三亚572000

出　　处：《河北医学》2022年第6期1020-1024,共5页Hebei Medicine

基　　金：海南省自然科学基金面上项目,(编号:818MS173)。

摘　　要：目的:分析丁苯酞序贯联合静脉溶栓对急性脑梗死患者小而密低密度脂蛋白胆固醇(Small dense low-density lipoprotein cholesterol,sdLDL-C)、膜联蛋白A2(Annexin A2)、同型半胱氨酸(Homocysteine,Hcy)及预后的影响。方法:选取本院2016年6月至2021年6月收治的148例急性脑梗死患者,以简单随机法分别纳入丁苯酞组、对照组,各74例,均行常规综合治疗及静脉溶栓,丁苯酞组加用丁苯酞序贯治疗。检测两组治疗前、治疗4周后血清sdLDL-C、Annexin A2、Hcy水平变化,并根据两组患者治疗前后美国国立卫生院(National Institute of Health Stroke Scale,NIHSS)神经功能缺损程度评分、Barthel指数(Barthel index,BI)变化评价其预后。结果:治疗4周后,两组患者血清sdLDL-C、Hcy均较治疗前下降,Annexin A2均较治疗前升高;丁苯酞组治疗4周后血清sdLDL-C、Hcy、Annexin A2变化幅度大于对照组(P<0.05)。治疗12周后,两组患者NIHSS评分均较治疗前下降,BI指数均较治疗前升高;丁苯酞组治疗12周后NIHSS评分、BI指数变化幅度大于对照组(P<0.05)。丁苯酞组、对照组治疗期间不良反应发生率分别为9.46%、10.81%,组间比较未见统计学差异(P>0.05)。结论:在静脉溶栓的基础上给予丁苯酞序贯治疗,不仅能够调节急性脑梗死患者sdLDL-C、Annexin A2、Hcy水平,还可通过促进神经功能及生活能力恢复从而改善患者预后质量,且安全性良好。Objective:To analyze the effect of sequential butylphthalide combined with intravenous thrombolysis on small dense low density lipoprotein cholesterol(sdLDL-C),annexin A2,homocysteine(Hcy)and prognosis in patients with acute cerebral infarction.Methods:Totally 148 patients with acute cerebral infarction admitted to our hospital from June 2016 to June 2021 were randomly divided into butylphthalide group and control group,74 cases in each group,all of which were treated with conventional comprehensive treatment and intravenous thrombolysis,while butylphthalide group was treated with butylphthalide sequentially.The levels of serum sdLDL-C,Annexin A2 and Hcy in the two groups were detected before and 4 weeks after treatment,and the prognosis was evaluated according to the changes of NIHSS neurological deficit score and Barthel index(BI)before and after treatment.Results:4 weeks after treatment,serum sdLDL-C and Hcy in both groups were lower than before treatment,and Annexin A2 was higher than before treatment;the changes of serum sdLDL-C,Hcy and Annexin A2 in phthalide group were larger than those in control group(P<0.05).12 weeks after treatment,the NIHSS score of both groups decreased and BI index increased;NIHSS score and BI index in phthalide group changed more than those in control group(P<0.05).The incidence of adverse reactions in butylphthalide group and control group during treatment was 9.46%and 10.81%respectively,and there was no statistical difference between the two groups(P>0.05).Conclusion:Sequential treatment with butylphthalide on the basis of intravenous thrombolysis can not only regulate the levels of sdLDL-C,Annexin A2 and Hcy in patients with acute cerebral infarction,but also improve the prognosis quality of patients by promoting the recovery of neurological function and living ability,with good safety.

关 键 词：急性脑梗死 丁苯酞 序贯治疗 静脉溶栓 膜联蛋白A2 

分 类 号：R743.3[医药卫生—神经病学与精神病学]