丁苯酞对急性缺血性脑卒中患者血清sICAM-1水平的影响及临床疗效观察

Effect of Dl-3-butylphthalide on the Expression of sICAM-1 Protein and the Neurological Function Improvement in Patients Subjected to Acute Ischemic Stroke

目的探讨急性缺血性脑卒中患者血清中sICAM-1表达水平的变化及丁苯酞胶囊的治疗作用。方法经中南大学伦理委员会批准,将入选119例符合诊断标准的急性缺血性脑卒中患者分为治疗组61例和对照组58例,另设健康组40例。在给予相同基础治疗的原则下,对照组给予阿司匹林肠溶片治疗20天,治疗组在对照组治疗基础上同时给予口服丁苯酞软胶囊0.2 g,每日3次,连服20天。观察比较治疗前、后第20天的患者血清sICAM-1含量变化、临床疗效及神经功能缺损评分(NIHSS)。结果与健康组比较,治疗组及对照组在治疗前血清sICAM-1水平明显升高(P<0.05),治疗组及对照组组间比较差异无显著性(P>0.05),在治疗20天后治疗组与对照组血清sICAM-1水平及NIHSS评分均较治疗前明显降低,与对照组相比较,治疗组临床疗效总有效率达81.97%,血清sICAM-1水平较治疗前下降明显。结论丁苯酞软胶囊改善急性脑梗塞患者神经功能缺损的机制可能与抑制血清sICAM-1水平有关。

Objective To observe the effect of D1-3-butylphthalide on the expression of sICAM-1 protein and the neuro- logical function improvement in patients with acute ischemic stroke. Methods After approved by the Central South University Committee on Ethics, 119 cases of acute ischemic stroke were randomly divided into treatment group （61 cases treated with D1-3- butylphthalide 200 mg tid po and routine therapy,totally 20 days） and control group （58 cases treated with routine therapy） ,40 health people were grouped into health group. The serum levels of sICAM-1 Protein were investigated before and 20 d after treat- ment,and NIHSS scores and clinical outcome were evaluated before and 20 d after treatment. Results M1 patients showed ob- vious improvement after treatment. However the therapeutic efficacy of treatment group was significantly better than that of routine group （P 〈0.05）. The serum levels of sICAM-1 protein of the treatment group was lower than that of the control group after 20 d （P〈0.05）. Conclusion Our research indicated that D1-3-butylphthalide can reduce the injury of ischemic brain cells and improve therapeutic efficacy probably through down regulation of serum of sICAM-1 protein expression.