丁苯酞序贯治疗大脑中动脉供血区急性梗死疗效观察

Efficacy Observation of dl-3-Butylphthalide in the Sequential Treatment of Acute Middle Cerebral Artery Infarction

目的：观察丁苯酞注射液及软胶囊对急性大脑中动脉供血区脑梗死患者序贯治疗的有效性和安全性。方法：61例起病72h内，美国国立卫生研究院卒中量表（NIHSS）评分5-25分的左侧大脑中动脉供血区急性脑梗死患者随机分为观察组（n=31）和对照组（n=30）。对照组仅予常规治疗，观察组在常规治疗基础上序贯给予丁苯酞注射液及丁苯酞软胶囊治疗。疗程均为90d。治疗前行NIHSS评分比较两组神经功能缺损程度，治疗后比较两组随访日常生活自理能力评定[Barthel指数（BI）和改良Rankin量表（mRS）]，并记录两组药品不良反应。结果：治疗前，两组患者NIHSS评分差异无统计学意义（P〉0．05）．治疗后观察组和对照组B1分别为（88．55±16．74）和（70．67±26．18），mRS分别为（1．87±1．02）和（2．53±1．40），观察组优于对照组（P〈0．05），两组药品不良反应发生率相似。结论：丁苯酞序贯治疗急性脑梗死有效且安全，能改患者善日常生活能力，改善90d远期预后。

Objective： To evaluate the efficacy and safety of dl-3-butylphthalide （NBP） injection and soft capsules in the treat- ment of acute middle cerebral artery infarction. Methods： Sixty-one patients with acute cerebral infarction in the left middle cerebral artery in 72 hours of onset of isehemic stroke with score of 5-25 according to the national institutes of health stroke scale （NIHSS） were randomly divided into the observation group （n = 31 ） and the control group （n = 30 ）. The control group was treated with the routine treatment, while the observation group was sequentially treated with NBP injection and soft capsules additionally. The treatment course was 90 days. Before the treatment, the NIHSS score was evaluated in both groups to compare the neurologic impairment degree. After the treatment, the daily living skills assessment was performed by Barthel index （BI） and modified Rankin score （mRS） , and the ad- verse reactions were recorded. Results ： Before the treatment, the NIHSS score in the two groups had no statistical significance （ P 〉 0.05）. After the treatment, the BI in the observation group and the control group was （88.55 ± 16.74） and （70.67 ± 26.18）, and mRS was （ 1.87 ± 1.02） and （2.53 ± 1.40） , respectively, suggesting the observation group had more favorable outcome than the con- trol group （P ≤ 0.05 ）. The incidence of adverse reactions had no significant difference between the groups. Conclusion： dl-3-Bu- tylphthalide sequential therapy should be regarded as an effective and safe method for acute cerebral infarction, which can improve the daily living skills and 90-day outcome of patients.