丁苯酞治疗急性脑梗死及其对血栓素A_2、前列环素及抗凝血酶Ⅲ的影响

Effects of butylphthalide on thromboxane A_2,prostacyclin and antithrombin Ⅲ in treatment of acute cerebral infarction

目的观察丁苯酞治疗急性脑梗死的疗效及其对血栓素A_2(TXA_2)、前列环素(PGI_2)、抗凝血酶Ⅲ(AT-Ⅲ)的影响。方法将100例急性脑梗死患者随机分为对照组和丁苯酞组。对照组患者给予常规治疗;丁苯酞组在对照组治疗的基础上给予丁苯酞治疗。2组疗程均为21d。2组患者于治疗前后检测神经功能缺损评分(NIHSS)、日常生活能力评分(Barthel指数)、脑梗死灶体积、TXB_2、6-Keto-PGF1a及AT-Ⅲ。结果治疗21d后,丁苯酞组的总有效率90.0%高于对照组74.0%(P<0.05);丁笨酞组NIHSS评分、Barthel指数、梗死灶体积、TXB_2、6-Keto-PGF1α及AT-Ⅲ均显著改善(P<0.05,P<0.01),对照组除梗死灶体积、AT-Ⅲ外,余指标亦显著改善(P<0.05,P<0.01),丁苯酞组均优于对照组(P<0.01或P<0.05);且其不良反应轻微。结论丁苯酞联用传统药物治疗急性脑梗死安全有效,能显著改善神经功能和日常生活能力,缩小梗死灶体积,降低TXA_2,提高PGI_2及AT-Ⅲ水平。

Objective To observe the influence of butylphthalide on curative effect and butylphthalide thromboxane A_2,prostacyclin and antithrombinⅢin treatment of acute cerebral infarction.Methods 100 cases of acute cerebral infarction were randomly divided into control group（50 cases）and butylphthalide group（50 cases）.The control group received conventional treatment.The butylphthalide group received butylphthalide treatment on the basis of the control group.Course of treatment was 21 days in two groups.To detect neurological deficit score（NIHSS）,activities of daily living score（Barthel index）, infarct volume,thromboxane A_2,prostacyclin and antithrombinⅢin patients of two groups before and after treatment. Results 21 days after treatment,the total effective rate in the butylphthalide group was higher than that in the control group （90.0%vs 74.0%,P 0.05）;NIHSS score,Barthel index,infarct volume,TXB_2,6-Keto-PGF1αand AT-Ⅲin the butylphthalide group were significantly better than that in the control group（P 0.01 or P 0.05）.The side effects of butylphthalide was much milder.Conclusion It is safe and effective that butylphthalide combined with traditional medicines in treatment of acute cerebral infarction,which can significantly improve neurological function and activities of daily living,reduce the size of the infarct,reducing thromboxane A_2,prostacyclin and antithrombinⅢlevels.