丁苯酞联合颈动脉支架置入术对急性缺血性卒中患者血管再通的研究及术后再狭窄的观察  

The Study of Vascular Recanalization and the Observation of Postoperative Restenosis in Patients with Acute Ischemic Stroke by Butylphthalide Combined with Carotid Artery Stenting

作　　者：曹灿 杨建豪 王睿琪 程光森 刘羽 李忠亮 李晓芬 方秦 罗玉鸿 宋梦姣 CAO Can;YANG Jianhao;WANG Ruiqi;CHENG Guangsen;LIU Yu;LI Zhongliang;LI Xiaofen;FANG Qin;LUO Yuhong;SONG Mengjiao(Department of Pharmaceuticals and Devices,Pingsha Community Health Service Center,Jinwan District,Zhuhai,Guangdong 519000,China;Department of Cerebrovascular Disease,Zhuhai People’s Hospital(The Affiliated Hospital of Beijing Institute of Technology,Zhuhai Clinical Medical College of Jinan University),Zhuhai,Guangdong 519000,China;Department of Pharmacy,Zhuhai People’s Hospital(The Affiliated Hospital of Beijing Institute of Technology,Zhuhai Clinical Medical College of Jinan University),Zhuhai,Guangdong 519000,China;Department of Medical section,Zhuhai People’s Hospital(The Affiliated Hospital of Beijing Institute of Technology,Zhuhai Clinical Medical College of Jinan University),Zhuhai,Guangdong 519000,China)

机构地区：[1]珠海市金湾区平沙社区卫生服务中心药械科,广东珠海519000 [2]珠海市人民医院(北京理工大学附属医院,暨南大学珠海临床医学院)脑血管病科,广东珠海519000 [3]珠海市人民医院(北京理工大学附属医院,暨南大学珠海临床医学院)药学部,广东珠海519000 [4]珠海市人民医院(北京理工大学附属医院,暨南大学珠海临床医学院)医务科,广东珠海519000

出　　处：《中国医药指南》2025年第12期6-9,共4页Guide of China Medicine

基　　金：珠海市医学科研基金项目(ZH24013310210073PWC);2024年度珠海市医学科研项目(2420009000077);国家自然科学基金青年科学基金项目(82303902);2023年珠海市社会发展领域科技计划项目(2320004000043)。

摘　　要：目的探讨丁苯酞联合颈动脉支架置入术对急性缺血性卒中患者血管再通的影响及对术后再狭窄的观察。方法回顾性纳入2021年1月至2022年12月珠海市人民医院41例急性缺血性卒中患者,分为对照组(21例)和观察组(20例),对照组采用颈动脉支架置入术和常规治疗,观察组在对照组的基础上,于术前开始给予丁苯酞氯化钠注射液治疗,采用改良脑梗死溶栓(mTICI)分级评价血管再通情况,术后mTICI分级达到2b或3级则表示血管再通成功,其中3级表示血管完全再通,比较两组患者术后的mTICI分级情况。统计两组患者术后3~6个月以颈动脉彩超或脑血管造影的方式复查发现术后再狭窄的例数。结果对照组术后mTICI分级为3级21例,观察组术后mTICI分级为2b级1例和3级19例,两组患者均实现术后血管再通成功,但是两组之间的差异无统计学意义(P>0.05)。两组患者CAS术后3~6个月返院复查共计22例,术后再狭窄的例数分别为对照组3例(23.08%)、观察组1例(11.11%),两组之间的差异无统计学意义(P>0.05)。结论颈动脉支架置入术前开始给予丁苯酞治疗,其对急性缺血性卒中患者血管再通情况(mTICI分级)和术后远期再狭窄未见明显影响。Objective To investigate the effect of butylphthalide combined with carotid artery stenting on vascular recanalization in patients with acute ischemic stroke and the observation of postoperative restenosis.Methods Forty-one patients with acute ischemic stroke in Zhuhai People’s Hospital from January 2021 to December 2022 were retrospectively included and divided into control group(21 cases)and observation group(20 cases).Carotid artery stenting and conventional treatment were applied to the control group,and the observation group was treated with butylphthalide and sodium chloride injection before surgery on the basis of the control group.Modified thrombolysis in cerebral infarction(mTICI)grade was used to evaluate vascular recanalization.The mTICI grade 2b or grade 3 indicated successful vascular recanalization,and the mTICI grade 3 indicated complete vascular recanalization.Postoperative mTICI grade was compared between the two groups.The number of cases of restenosis detected by carotid color ultrasound or cerebral angiography 3-6 months after operation in the two groups were counted.Results In the control group,there were 21 patients with postoperative mTICI grade 3.In the observation group,there were 1 patient with postoperative mTICI grade 2b and 19 patients with postoperative mTICI grade 3.Postoperative vascular recanalization was successful in both groups.But there was no significant difference between the two groups(P>0.05).A total of 22 patients in both groups returned to the hospital for re-examination 3-6 months after CAS surgery.The number of restenosis cases was 3(23.08%)in the control group and 1(11.11%)in the observation group,and there was no significant difference between the two groups(P>0.05).Conclusions Butylphthalide therapy,which began before carotid artery stenting,had no significant effect on vascular recanalization(mTICI grade)and post-operative restenosis in patients with acute ischemic stroke.

关 键 词：丁苯酞 急性缺血性卒中 颈动脉支架置入术 血管再通 再狭窄 

分 类 号：R743.3[医药卫生—神经病学与精神病学]