丁苯酞氯化钠注射液联合双联抗血小板药物治疗进展性脑梗死的效果观察

Effect of butylphthalide sodium chloride injection combined with dual antiplatelet drugs on patients with progressive cerebral infarction

目的探讨丁苯酞氯化钠注射液联合双联抗血小板药物治疗进展性脑梗死(PCI)的效果。方法抽取周口市第一人民医院2020年1月至2020年12月收治的PCI患者96例,按随机数字表法分为观察组与对照组,每组48例。两组均给予常规治疗,对照组另给予双联抗血小板药物(阿司匹林+氯吡格雷)治疗,观察组在对照组基础上给予丁苯酞氯化钠注射液治疗。比较两组疗效,治疗前后脑血流动力学[平均血流速度(Vmean)、收缩期峰值血流速度(Vmax)、搏动指数(PI)]、凝血功能[凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体(D-D)、血浆纤维蛋白原(FIB)]、病情相关因子[β1-淀粉样蛋白(Aβ1-42)、神经元特异性烯醇化酶(NSE)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、美国国立卫生院卒中量表(NIHSS)评分、日常生活活动能力(ADL)评分及匹兹堡睡眠质量指数(PSQI)评分变化。结果观察组总有效率(97.92%,47/48)高于对照组(85.42%,41/48),P<0.05。治疗后,观察组Vmean、Vmax均高于对照组,PI、FIB、D-D、NSE、Aβ1-42、TNF-α、IL-6均低于对照组,PT、TT、APTT均长于对照组(P均<0.05)。治疗后,观察组NIHSS、PSQI评分均低于对照组,ADL评分高于对照组(P<0.05)。结论丁苯酞氯化钠注射液联合双联抗血小板药物治疗PCI效果确切,能有效促进脑动脉血流,改善凝血功能,降低脑卒中风险,缓解炎症及氧化应激反应,提高患者生活能力及睡眠质量。

Objective To investigate the clinical effect of butylphthalide sodium chloride injection combined with dual antiplatelet drugs in the treatment of progressive cerebral infarction(PCI).Methods Ninety-six PCI patients treated in Zhoukou First People’s Hospital from January 2020 to December 2020 were selected,and they were divided into observation group and control group according to the random number table method,with 48 cases in each group.Both groups were given conventional treatment.The control group was given dual antiplatelet drugs(aspirin+clopidogrel),based on conventional treatment;and the observation group was given butylphthalide sodium chloride injection,based on the treatment of the control group.The curative effect,preoperative and postoperative cerebral hemodynamics,including mean blood flow velocity(Vmean),peak systolic blood flow velocity(Vmax),pulsatility index(PI),blood coagulation function assessed by thrombin time(TT),prothrombin(PT),activated partial thromboplastin time(APTT),D-dimer(D-D),plasma fibrinogen(FIB),disease-related factors,including amyloidβ1-42(Aβ1-42),neuron-specific enolase(NSE),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),the National Institutes of Health Stroke Scale(NIHSS)score,activities of daily living(ADL)score,and Pittsburgh sleep quality index(PSQI)score were compared between the two groups.Results The total effective rate of the observation group was 97.92%(47/48),higher than the 85.42%(41/48)of the control group(P<0.05).After treatment,Vmean and Vmax of the observation group were higher than those of the control group,while PI,FIB,D-D,NSE,Aβ1-42,TNF-αand IL-6 were lower than those of the control group,moreover,PT,TT and APTT were longer than those of the control group(all P<0.05).After treatment,the NIHSS and PSQI scores of the observation group were lower than those of the control group,and the ADL score was higher than that of the control group(P<0.05).Conclusions Butylphthalide sodium chloride injection combined with dual antiplatelet drugs has a definite effect in the treatment of PCI.It can effectively promote cerebral arterial blood flow,improve coagulation function,reduce the risk of stroke,alleviate inflammation and oxidative stress,and improve the life ability and sleep quality.