普罗布考联用丁苯酞治疗急性脑梗死的临床观察

Clinical Observation of Probucol Combined with Butyphthalide in the Treatment of Patients with Acute Cerebral Infarction

目的：探讨普罗布考联用丁苯酞治疗急性脑梗死的临床疗效及安全性。方法：172例急性脑梗死患者按随机数字表法分为观察组与对照组,各86例。两组患者均接受急性脑梗死常规治疗,包括发病4.5 h内溶栓、抗血小板聚集、降颅压、营养支持、强化降脂等,并及时处理基础疾病。对照组患者在此基础上给予普罗布考片口服,每次0.5 g,bid。观察组患者在对照组治疗基础上加用丁苯酞氯化钠注射液,每次100 ml,bid,分别于每天9：00、17：00静脉滴注,50~90 min内滴注完毕。两组均持续治疗2周。观察两组患者治疗前后脂质代谢指标和血清S100β蛋白、神经元特异性烯醇化酶（NSE）、超敏C反应蛋白（hs-CRP）水平,美国国立卫生院卒中量表（NIHSS）评分,临床疗效及不良反应发生情况。结果：与治疗前比较,两组患者治疗后的三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）水平均显著下降,高密度脂蛋白胆固醇水平均显著上升,且观察组患者的TG、TC、LDLC水平下降得更明显,差异均有统计学意义（P〈0.05）;两组患者治疗后的血清S100β蛋白、NSE、hs-CRP水平及NIHSS评分均显著降低,且观察组患者的NSE水平及NIHSS评分降低得更明显,差异均有统计学意义（P〈0.05）。观察组患者的总有效率为89.5%,显著高于对照组的62.8%,差异有统计学意义（P〈0.05）。两组患者治疗期间均未见明显不良反应发生,亦未见肝肾功能、凝血功能和心电图有明显变化。结论：普罗布考联用丁苯酞能够有效改善急性脑梗死患者的脂质代谢,降低血清NSE水平,对患者神经功能的早期恢复具有积极作用。

OBJECTIVE：To explore the efficacy and safety of probucol combined with butylphthalide in the treatment of patients with acute cerebral infarction. METHODS：172 patients with acute cerebral infarction were randomly divided into observation group and control group,86 cases in each group. All patients received conventional treatment for acute cerebral infarction,including thrombolysis,anti-platelet aggregation,reducing intracranial pressure,nutritional support,intensive lipid-lowering within onset4.5 h,timely treatment of the underlying diseases;based on it,control group received Probucol tablet,0.5 g every times,bid. Observation group additionally received Butylphthalide and sodium chloride injection,100 ml every times,bid,in 9：00 and 17：00 every day,infusion within 50-90 min. Both groups lasted for 2 weeks. Lipid metabolic indexes,the changes of serum S100β,NSE and hs- CRP levels,NIHSS score,clinical efficacy before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS：Compared with before treatment,triglyceride（TG）,total cholesterol（TC）and low-density lipoprotein cholesterol（LDL- C） levels in 2 groups significantly decreased,high- density lipoprotein cholesterol level significantly increased,and TG,TC and LDL-C levels in observation group decreased more significantly,the differences were statistically significant（P〈0.05）. Serum S100β,NSE and hs-CRP levels and NIHSS scores in 2 groups significantly decreased,and NSE level NIHSS scores and in observation group decreased more significantly,the differences were statistically significant（P〈0.05）. The total effective rate in observation group was 89.5%,significantly higher than control group（62.8%）,the difference was statistically significant（P〈0.05）. There were no obvious adverse reactions during treatment,and also no obvious liver and kidney function,blood coagulation and ECG changes. CONCLUSIONS：Probucol combined with butylphthalide can effectively improve the lipid metabolism and decrease serum NSE level in the treatment of patients with acute cerebral infarction,and plays positive role in early recovery of neurological function.