丁苯酞联合双抗血小板治疗可改善急性脑梗死患者凝血功能和神经功能

Butylphthalide combined with dual antiplatelet therapy improves coagulation function and neurological function in patients with acute cerebral infarction

目的探究丁苯酞联合常规双抗血小板治疗对急性脑梗死(ACI)患者凝血功能和神经功能的影响。方法选取2017年10月-2019年10月济宁市第一人民医院收治的ACI患者106例,用随机数表法分为观察组(n=53)和对照组(n=53)。对照组给予常规双抗血小板(阿司匹林+氯吡格雷)治疗,观察组在此基础上加服丁苯酞软胶囊,连续治疗1个月后,比较两组患者的临床疗效、凝血功能和神经功能变化情况。结果观察组治疗总有效率为90.57%(48/53),高于对照组的75.47%(40/53),差异有统计学意义(U=5.768,P=0.016)。治疗后,两组患者的凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、改良Barthel指数(BI)和神经生长因子(NGF)水平均有所上升(P<0.05),美国国立卫生研究院卒中量表(NIHSS)评分、血清S-100β和神经元特异性烯醇化酶(NSE)水平均有所下降(P<0.05),且观察组TT、PT、APTT、BI评分、NGF水平明显高于对照组,NIHSS评分、血清S-100β、NSE水平明显低于对照组(P均<0.05)。结论丁苯酞联合常规双抗血小板在治疗ACI方面疗效确切,能有效改善患者的凝血功能和神经功能,具有较好的神经细胞保护作用,值得临床推广与应用。

Objective To investigate the effect of butylphthalide combined with routine dual antiplatelet therapy on coagulation and neurological function in patients with acute cerebral infarction(ACI).Methods A total of 106 patients with ACI who were admitted and treated in the hospital between October 2017 and October 2019 were selected.They were divided into observation group(n=53)and control group(n=53)by random number table method.The control group was given routine dual antiplatelet therapy with aspirin and clopidogrel,and the observation group was treated with oral butylphthalide soft capsules based on the treatment of control group.After 1 month of continuous treatment,the clinical efficacy,changes of coagulation function and neurological function were compared between the two groups.Results The total response rate of the observation group(90.57%)was higher than that of the control group(75.47%)(U=5.768,P=0.016).After treatment,the thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT),modified Barthel index(BI)and nerve growth factor(NGF)levels in both groups were increased,while the National Institutes of Health stroke scale(NIHSS)scores,serum S-100βand neuron-specific enolase(NSE)levels were decreased(P<0.05).Besides,TT,PT,APTT,BI score and NGF levels in the observation group were significantly longer/higher than those in the control group.NIHSS score,serum S-100βand NSE levels were significantly lower than those in the control group(P<0.05).Conclusions Butylphthalide combined with routine dual antiplatelet therapy was effective in the treatment of ACI.It could effectively improve the coagulation function and neurological function of patients,with good neuroprotective effect.