前列地尔对进展型脑梗死患者炎症反应及预后的影响

Effect of Alprostadil on inflammation and prognosis of patients with progressive cerebral infarction

目的探讨前列地尔对进展型脑梗死患者炎症反应及预后的影响。方法 98例进展型脑梗死患者随机分为2组,对照组49例采用常规治疗加用血塞通,观察组49例采用常规治疗加用前列地尔。治疗31d后评价疗效。治疗前后采用卒中量表(NIHSS)及日常生活活动量表Barthel指数(BI)进行评分。治疗前后测定血清C反应蛋白(CRP)、单核细胞趋化因子-1(MCP-1)和S100B蛋白。结果 2组治疗前血清CRP和MCP-1无明显差异(P>0.05)。治疗后2组血清CRP和MCP-1均有明显降低(P<0.05,P<0.01)。2组治疗后比较,血清CRP和MCP-1均降低更明显(P<0.05)。2组治疗后NIHSS评分均有明显降低,与对照组比较,观察组降低更明显(P<0.05)。2组治疗后BI指数均有明显升高,与对照组比较,观察组升高更明显(P<0.05)。治疗后2组血清S100B蛋白均有明显降低(P<0.01),治疗后观察组降低比对照组更明显(P<0.05)。结论前列地尔可以减轻进展型脑梗死患者炎症反应而改善神经功能。

Objective To study the effect of alprostadil on inflammation and prognosis of patients with progressive cerebral infarction.Methods 98 patients with progressive cerebral infarction were randomly divided into two groups ,the control group （n=49 cases） was treated with the conventional methods plus xuesetong ,and the observation group（n=49 cases） was treated with the conventional methods plus alprostadil. The efficacy of the two groups was evaluated after treatment for 31 days. Be-fore and after treatment ,the Stroke Scale （Natinal Institutes of Health Stroke Scale ,NIHSS） and the activities of Daily Living Scale （Barthel index ,BI） were used to evaluate their motor function. Serum C-reactive protein （CRP） ,monocyte chemotactic factor-1 （MCP-1） and S100B protein were detected before and after treatment.Results Before treatment ,there were no signifi-cant difference in serum CRP and MCP-1 between two groups （P〉0.05）. After treatment ,serum CRP and MCP-1 were sig-nificantly lower than those before treatment （P〈 0.05 , P〈 0.01）. And compared with the control group ,serum CRP and MCP-1 of the observation group were significantly decreased （P〈 0.05）. After treatment ,NIHSS scores were significantly lower. Compared with the control group ,NIHSS scores of the observation group significantly decreased （P〈0.05）. BI index after treatment were significantly increased. Compared with the control group ,BI index of the observation group increased more significantly （P〈0.05）. After treatment ,serum S100B protein were significantly lower （P〈0.01）. Compared with the control group ,serum S100B protein of the observation group significantly decreased after treatment （P〈0.05）.Conclusion Alprostadil can reduce inflammation in patients with progressive cerebral infarction and improve neurological function.