急性脑梗死介入治疗后应用丁苯酞联合依达拉奉改善神经功能恢复的临床研究

Clinical study of the improvement of butylphthalide combined with edaravone therapy on neural functional recovery in acute cerebral infarction after interventional therapy

目的：研究急性脑梗死介入治疗后丁苯酞联合依达拉奉治疗对神经功能恢复的改善价值。方法：将2012年5月~2015年5月在我院接受介入治疗的急性脑梗死患者68例随机分为抗氧化组和对照组,对照组34例接受常规抗血小板和降脂治疗,抗氧化组34例在常规治疗基础上加用丁苯酞、依达拉奉,测定血清中氧自由基、氧化产物、抗氧化物质以及S100β的含量。结果：治疗后3 d时,抗氧化组和对照组血清中羟自由基（·OH）、超氧阴离子自由基（·O_2）、一氧化氮自由基（NO·）、硝基自由基（·ONOO-）的含量均低于介入术后即刻（P〈0.05）,抗氧化组治疗后3 d血清中·OH、·O_2、NO·、·ONOO-含量均低于对照组（P〈0.05）;治疗后3 d时,抗氧化组血清中丙二醛（MDA）、晚期氧化蛋白产物（AOPP）的含量显著低于对照组（P〈0.05）,超氧化物歧化酶（SOD）、谷胱甘肽（GSH）的含量显著高于对照组（P〈0.05）;治疗后3、5、7 d时,抗氧化组和对照组血清中S100β的含量均低于介入术后即刻（P〈0.05）,抗氧化组治疗后3、5、7 d时的血清S100β含量均低于对照组（P〈0.05）。结论：急性脑梗死介入治疗后丁苯酞联合依达拉奉治疗能够改善神经功能恢复,该治疗方案发挥作用的分子靶点是清除氧自由基。

Objective： To study the improvement value of butylphthalide combined with edaravone therapy on neural functional recovery in acute cerebral infarction after interventional therapy. Methods： Patients with acute cerebral infarction who received interventional therapy in our hospital from May 2012 to May 2015 were randomly divided into antioxidant group and control group. Control group received conventional anti-platelet and lipid-lowering therapy,antioxidant group received butylphthalide and edaravone on the basis of conventional treatment,and the levels of serum oxygen free radicals,oxidation products,antioxidants and S100β were determined. Results： Three days after treatment,serum ·OH,·O_2,NO· and ·ONOO-content of both antioxidant group and control group were lower than those instantly after interventional therapy,and serum ·OH,·O_2,NO· and ·ONOO-content of antioxidant group 3 days after treatment were lower than those of control group; Three days after treatment,serum MDA and AOPP content of antioxidant group were significantly lower than those of control group while SOD and GSH content were significantly higher than those of control group; Three days,five days and seven days after treatment,serum S100β levels of both antioxidant group and control group were lower than those instantly after interventional therapy,and serum S100β levels of antioxidant group 3 days,5 days and 7 days after treatment were lower than those of control group. Conclusions： Butylphthalide combined with edaravone therapy for acute cerebral infarction after interventional therapy can improve neural functional recovery,and the functioning molecular target of the treatment is to remove oxygen free radicals.