丁苯酞联合替罗非班治疗进展性脑梗死的疗效及对血清IL-18、NLRP3炎性小体的影响  

The Efficacy of Butylphthalide Combined with Tirofiban for Progressive Cerebral Infarction and Its Influence on Serum Il-18 and Nlrp3 Inflammasome

作　　者：张亮 陈胜会[1] 郑丽霞 ZHANG Liang;CHEN Shenghui;ZHENG Lixia(Department of Neurology,Suzhou Kowloon Hospital,Shanghai Jiao Tong University School of Medicine,Suzhou,Jiangsu 215028,China)

机构地区：[1]上海交通大学医学院苏州九龙医院神经内科,江苏苏州215028

出　　处：《转化医学杂志》2024年第5期806-810,共5页Translational Medicine Journal

基　　金：苏州市医学重点扶持学科项目(SZFCXK202128)。

摘　　要：目的探究丁苯酞联合替罗非班治疗进展性脑梗死的疗效及对血清白细胞介素-18(IL-18)、炎性小体NOD样受体热蛋白结构域相关蛋白3(NLRP3)的影响。方法回顾性分析2020年10月至2023年10月上海交通大学医学院苏州九龙医院收治的80例急性进展性脑梗死患者的临床资料,依据治疗方式进行分组。其中40例接受替罗非班治疗,纳入参照组,另外40例患者在此基础上应用丁苯酞治疗,纳入研究组。对比2组患者的治疗效果、神经功能、血清IL-18、NLRP3、同型半胱氨酸(Hcy)、C反应蛋白(CRP)、日常生活能力评定及不良反应。结果研究组患者有效率高于参照组(P<0.05);研究组患者治疗后美国国立卫生研究院卒中量表(NIHSS)评分低于参照组(P<0.05);研究组患者治疗后血清IL-18、NLRP3、Hcy、CRP水平均低于参照组(P<0.05);研究组患者治疗后日常生活能力评分均高于参照组(P<0.05)。2组患者不良反应发生率比较差异统计学意义(P>0.05)。结论丁苯酞联合替罗非班治疗可下调进展性脑梗死患者的血清IL-18、NLRP3、Hcy、CRP水平,改善神经功能、日常生活能力,且不良反应少,安全性高。Objective To explore the efficacy of Butylphthalide combined with Tirofiban for progressive cerebral infarction and its influence on serum interleukin-18(IL-18)and inflammasome NOD-like receptor pyrin domain-containing protein 3(NLRP3).Methods Clinical data of 80 patients with acute progressive cerebral infarction admitted to Suzhou Kowloon Hospital from October 2020 to October 2023 were retrospectively analyzed.Patients were divided into the reference group(n=40,Tirofiban only)and the study group(n=40,Butylphthalide combined with Tirofiban)according to treatment methods.The therapeutic effect,neurological function,serum IL-18,NLRP3,homocysteine(Hcy),C-reactive protein(CRP),evaluation of daily living ability,and adverse reactions were compared between the two groups.Results The effective rate of treatment in the study group was higher than that in the reference group(P<0.05),while the mean National Institutes of Health Stroke Scale(NIHSS)score after treatment was lower(P<0.05).The levels of IL-18,NLRP3,Hcy,and CRP in the study group were lower than those in the reference group after treatment(P<0.05),while the scores for daily living ability were higher(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Butylphthalide combined with Tirofiban can effectively reduce serum IL-18,NLRP3,Hcy,and CRP levels in patients with progressive cerebral infarction,improve neurological function and daily living ability,and is associated with few side effects and high safety.

关 键 词：急性进展性脑梗死 NLRP3 神经功能 丁苯酞注射液 IL-18 

分 类 号：R743.33[医药卫生—神经病学与精神病学]