丁苯酞对急性脑梗死患者NSE、IL-6、TNF-α表达水平的影响

Effects of butylphthalide on NSE,IL-6 and TNF-α in acute cerebral infarction patients

目的探讨丁苯酞对急性脑梗死患者神经元特异性烯醇化酶(NSE)及炎症因子白介素6(IL-6)、肿瘤坏死因子α(TNF-α)表达水平的影响。方法收集我院97例发病在48 h内的急性脑梗死患者,并由头颅CT或MR证实诊断,其中丁苯酞组42例,常规治疗组55例。分别于治疗前及治疗后第7、14天对两组患者进行神经功能缺损程度评分(NIHSS评分),并检测其血清NSE、IL-6、TNF-α水平。结果治疗前,两组患者的NIHSS评分及血清NSE、IL-6、TNF-α比较差异无统计学意义(P>0.05)。治疗后第7天,丁苯酞组的NIHSS评分较常规治疗组有好转趋势,但差异无统计学意义(P=0.14);治疗后第14天,丁苯酞组的NIHSS评分显著低于常规治疗组(P=0.03)。治疗后第7、14天,丁苯酞组的NSE(P=0.04,P=0.02)、IL-6(P=0.02,P=0.01)、TNF-α(P=0.01,P=0.03)水平较常规治疗组均有所下降。结论丁苯酞能有效促进神经功能缺损的恢复,其机制可能与下调IL-6、TNF-α等促炎因子表达与减轻炎症相关。

Objective To explore the effects of butylphthalide on neuron specific enolase（ NSE）,interleukin-6（ IL-6） and tumor necrosis factor-α（ TNF-α） in acute cerebral infarction（ ACI） patients. Methods Ninety-seven ACI patients（ within 48 h） diagnosed by CT or MR were divided into butylphthalide group（ n = 42） and routine group（ n = 55）. The scores of the neurological deficits（ NIHSS） of the patients in both groups were compared before treatment,and on the 7th and 14 th day of treatment,and the serumlevels of NSE,IL-6 and TNF-α were measured at the same time. Results There was no significant difference between the two groups in the NIHSS score and the serumlevels of NSE,IL-6 and TNF-α（ P 〉0. 05） before treatment. The NIHSS score of butylphthalide group was significantly lower than that of routine group（ P = 0. 03） after 14 d of treatment. The NSE（ P = 0. 04,P = 0. 02）,IL-6（ P = 0. 02,P = 0. 01） and TNF-α（ P = 0. 01,P = 0. 03） of butylphthalide group were also significantly lower than those of routine group on the 7th and 14 th day of treatment respectively. Conclusion Butylphthalide can promote the recovery of the neurological function in patients with acute cerebral infarction by decreasing the levels of inflammatory factors,such as IL-6 and TNF-α,and improve the inflammation.