丁苯酞序贯疗法联合双联抗血小板对急性脑梗死患者血清HMGB1、MMP-9、3-MST、Fibulin-5的影响

Influence of butyphthalide sequential therapy combined with dual anti-platelet therapy on serum levels of HMGB1,MMP-9,3-MST,Fibulin-5 in patients with ACI

目的观察丁苯酞序贯疗法联合双联抗血小板对急性脑梗死(ACI)患者血清高迁移率族蛋白B1(HMGB1)、基质金属蛋白酶-9(MMP-9)、巯基丙酮酸硫基转移酶-3(3-MST)和扣针蛋白-5(Fibulin-5)的影响。方法选取2014年4月至2018年4月本院收治的ACI患者104例,随机分为观察组和对照组各52例。对照组给予常规治疗和双联抗血小板治疗,观察组在对照组基础上加用丁苯酞序贯疗法。比较两组临床预后,治疗前后评价美国国立卫生研究院卒中量表(NIHHS)、FuglMeyer量表(FMA)、改良Barthel指数(MBI)和简易精神状态量表(MMSE)评分,并测定外周血HMGB1、MMP-9、3-MST、Fibulin-5水平。结果治疗28d、3个月后,观察组的NIHSS评分、FMA评分、MBI和MMSE评分均优于对照组,差异有统计学意义(P<0.05);治疗第3d、7d、28d,观察组血清HMGB1、MMP-9、Fibulin-5低于对照组,3-MST高于对照组,差异均有统计学意义(P<0.05);观察组预后良好率为88.46%,高于对照组的71.15%,差异有统计学意义(P<0.05)。结论丁苯酞序贯疗法联合双联抗血小板治疗ACI能够保护患者的神经功能,促进神经功能、运动功能及认知功能的恢复,并提高日常生活活动能力,其机制可能与降低血清HMGB1、MMP-9、Fibulin-5和上调3-MST有关。

Objective To observe the influence of butyphthalide sequential therapy combined with dual antiplatelet therapy on serum levels of high mobility group box 1 protein(HMGB1),matrix metalloproteinase-9(MMP-9),3-mercaptopyruvate sulfurtransferase(3-MST),Fibulin-5 in patients with acute cerebral infarction(ACI).Methods From April 2014 to April 2018,a total of 104 patients with ACI admitted to our hospital were randomly divided into the observation group and the control group,with 52 cases in each group.The control group received routine treatment and dual anti-platelet therapy,the observation group received butyphthalide sequential therapy on the basis of the control group.The clinical prognosis of the two groups were compared.The National Institutes of Health Stroke Scale(NIHHS),Fugl-Meyer scale(FMA),modified Barthel index(MBI)and the Mini Mental State Examination(MMSE)scores were evaluated,the serum levels of HMGB1,MMP-9,3-MST,fibulin-5 before and after treatment were measured.Results 28 d and 3 months after treatment,the NIHSS score,FMA score,MBI and MMSE score of the observation group were better than the control group,the differences were statistically significant(P<0.05).The serum levels of HMGB1,MMP-9,Fibulin-5 were lower than the control group and the 3-MST was higher than the control group on the 3 rd,7 th,28 th days after treatment,the differences were statistically significant(P<0.05).The good prognosis rate of the observation group was 88.46%,which was higher than 71.15%of the control group,the difference was statistically significant(P<0.05).Conclusion Butyphthalide sequential therapy combined with dual anti-platelet therapy could protect the nerve function and improve the nerve function,motor function,cognitive function and the ability of daily living of patients with ACI.The treatment mechanism may be related to the reduction of serum HMGB1,MMP-9,Fibulin-5 and the up regulation of 3-MST.