丁苯酞联合抗血小板药物治疗高龄老年脑梗死的疗效观察

Efficacy of butylphthalide combined antiplatelet treatment on cerebral infarction in elderly

目的:观察丁苯酞联合阿司匹林、氯吡格雷治疗高龄老年脑梗死的疗效。方法:收集我院神经内科2012年1月至2015年6月入院治疗的高龄老年(≥80岁)脑梗死病例221例,按治疗方法分为4组:单抗组、双抗组、丁苯酞+单抗组、丁苯酞+双抗组。分别观察各组患者治疗4周前后的神经功能缺损评分(NIHSS评分)和血浆C反应蛋白(plasma C-reactive protein,CRP)水平的变化,对比4组间的NIHSS评分差值、CRP差值和临床治疗总有效率。结果:各组治疗前后NIHSS评分和血浆CRP水平均有显著差异(P<0.05),各组NIHSS评分差值及血浆CRP水平差值变化趋势一致:丁苯酞+双抗组与其它3组均有显著差异(P<0.05),丁苯酞+单抗组与双抗组之间无显著差别(P>0.05)。各组临床治疗总有效率比较:丁苯酞+双抗组治疗效果显著优于其它3组(P<0.05),丁苯酞+单抗组总有效率显著高于单抗组(P<0.05),丁苯酞+单抗组和双抗组的临床总有效率无明显差别(P>0.05)。结论:丁苯酞能显著提高抗血小板药物治疗高龄老年脑梗死的临床疗效。

Objective： To investigate the effect of butylphthalide in combination with aspirin and/or clopidogrel in treating cerebral infarction of elderly. Methods： The clinical data of 221 cerebral infarction patients（≥80 years old） who underwent both antiplatelet drug therapies systematically and butylphthalide combined antiplatelet treatment in our hospital from Jan 2012 to Jun 2015 were reviewed. All cases were divided into 4 groups： aspirin group, aspirin and clopidogrel group, butylphthalide combined aspirin group, butylphthalide combined aspirin and clopidogrel group. The National Institute of Health stroke scale（NIHSS） score, plasma C-reactive protein（CRP） level and clinical efficacy after 4 weeks therapy of each group was analyzed respectively. Results： By systematic medication therapy, both NIHSS score and CRP level of each group were improved significantly（P〈0.05）, and the changes from pre- to post-treatment of above-mentioned parameters in each group showed consistent. Ebutylphthalide combined aspirin and clopidogrel group was more effective when compared to the other 3 groups in NIHSS score or CRP level（P〈0.05）. However, there was no remarkable difference between butylphthalide combined aspirin group and aspirin and clopidogrel group in respect of NIHSS score and CRP level（P〈0.05）. Additionally, the clinical efficacy in butylphthalide combined aspirin and clopidogrel group was better than other groups significantly（P〈0.05）, better clinical efficacy in butylphthalide combined aspirin group than aspirin group significantly（P〈0.05）, whereas no difference existed between aspirin and clopidogrel group and butylphthalide combined aspirin group about clinical efficacy（P〉0.05）. Conclusion： Butylphthalide can significantly improve antiplatelet therapy in elderly cerebral infarction.