丁苯酞联合溶栓治疗急性脑梗死的疗效及不良预后相关分析  

Analysis of the efficacy and adverse prognosis of combination therapy with butylphthalide and thrombolysis for acute cerebral infarction

作　　者：马龙[1] 凡奇[1] 李强 刘彦龙 梁海[1] MA Long;FAN Qi;LI Qiang;LIU Yanlong;LIANG Hai(Department of Neurology,Bozhou People′s Hospital,Bozhou Anhui 236800,China)

机构地区：[1]亳州市人民医院神经内科,安徽亳州236800

出　　处：《中国急救复苏与灾害医学杂志》2024年第7期896-899,977,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：安徽省重点研究与开发项目(编号:2022e07020066)。

摘　　要：目的 探索丁苯酞联合溶栓治疗急性脑梗死的疗效及影响预后不良的独立因素。方法 选取的80例急性脑梗死患者均行丁苯酞联合溶栓治疗,治疗14 d。比较治疗前、治疗后7 d及14 d的神经功能、生活质量,且采用酶联免疫吸附法测定血清指标,经颅多普勒超声评估大脑中动脉的峰流速和平均流速。同时,根据预后情况分为两组,以改良Rankin量表(mRS)评分为判定标准,mRs评分0~2分为预后良好,mRs评分≥3分为预后不良,经二元Logistic回归分析影响预后的独立因素。结果 患者治疗后的Barthel指数(BI)评分、大脑中动脉峰值、大脑中动脉平均流速高于治疗前,C反应蛋白(CRP)、尿酸(UA)、肌酸激酶(CK)、脑钠肽(BNP)、美国国立卫生研究院卒中量表(NIHSS)评分、mRs评分低于治疗前(P<0.05)。经单因素分析,年龄、溶栓后出血、溶栓前血糖、发病至溶栓时间、梗死部位、入院时血压异常会对预后造成影响(P<0.05),经二元Logistic回归分析,年龄>70岁、发病至溶栓时间≥3 h、入院时血压异常是影响患者预后的独立因素。结论 丁苯酞联合溶栓治疗急性脑梗死患者效果显著,可促进神经功能恢复,改善脑部血流动力学,但预后受发病至溶栓时间、年龄、血压等因素影响。Objective To exploring the efficacy of combination therapy with butylphthalide and thrombolysis in the treatment of acute cerebral infarction and the independent factors affecting poor prognosis.Methods The selected 80patients with acute cerebral infarction were all admitted between February 2020 and February 2023,and all received treatment with combination of butylphthalide and thrombolysis.After 14 days of treatment,the neurological function and quality of life were compared before treatment,7 days after treatment,and 14 days after treatment.Serum indicators were measured using enzyme-linked immunosorbent assay,and the peak and average flow velocities of the middle cerebral artery were evaluated by transcranial Doppler ultrasound.At the same time,the patients were divided into two groups based on their prognosis.The modified Rankin Scale(mRS) score was used as the criterion,with an mRs score of 0-2 indicating a good prognosis and an mRs score of ≥ 3 indicating a poor prognosis.Independent factors affecting prognosis were analyzed using binary Logistic regression.Results After treatment,the Barthel index(BI)score,peak value of the middle cerebral artery,and average flow velocity of the middle cerebral artery of the patient were higher than before treatment,while C-reactive protein(CRP),uric acid(UA),creatine kinase(CK),brain natriuretic peptide(BNP),National Institutes of Health Stroke Scale(NIHSS) score,and mRs score were lower than before treatment(P<0.05).Through univariate analysis,age,post thrombolytic bleeding,pre thrombolytic blood glucose,time from onset to thrombolysis,infarct site,and abnormal blood pressure upon admission can have an impact on prognosis(P<0.05).Through binary Logistic regression analysis,age>70 years old,time from onset to thrombolysis ≥3 hours,and abnormal blood pressure upon admission are independent factors affecting patients' prognosis.Conclusion The combination of butylphthalide and thrombolysis has a significant effect on patients with acute cerebral infarction,promoting the

关 键 词：丁苯酞 溶栓 急性脑梗死 不良预后 相关 分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]