丁苯酞注射液治疗老年急性脑梗死患者的疗效及其对脑血流动力和脑血管储备能力的影响

Therapeutic effect of Butylphthalide Injection in elderly patients with acute cerebral infarction and its influence in cerebral hemodynamics and cerebral vascular reserve

目的:探讨丁苯酞注射液治疗老年急性脑梗死(ACI)患者的疗效及其对脑血流动力和脑血管储备能力(CVR)的影响,阐明丁苯酞对ACI患者的药理作用机制。方法:选取100例老年ACI患者作为研究对象,按入院病例号的单、双号将其分为观察组和对照组,每组各50例。对照组患者给予常规治疗方法进行治疗,观察组患者在常规治疗方案的基础上加用丁苯酞注射液进行治疗。观察2组患者治疗前后的美国国立卫生研究院卒中量表(NIHSS)评分、双侧大脑中动脉(MCA)的峰流速(Vp)、平均流速(Vm)及差值(DVp、DVm)等脑血流动力学指标和脉动指数(PI)以及CVR,并进行比较;对2组患者的临床疗效进行评价和比较。结果:治疗后观察组患者NIHSS评分明显低于对照组(t=15.420,P<0.05),观察组患者疗效分布和临床有效率均优于对照组(U=2.225,χ~2=5.005,P<0.05);观察组患者治疗后Vp和Vm明显高于对照组(t=10.819,t=7.259,P<0.05),而DVp和DVm明显低于对照组(t=16.348,t=19.055,P<0.05);观察组患者治疗后的CVR明显高于对照组(t=6.884,P<0.05),PI明显低于对照组(t=4.979,P<0.05)。结论:丁苯酞注射液可有效纠正ACI患者的脑血流动力异常,提升机体稳定脑血管灌注量的能力,改善ACI患者的神经功能缺损症状,提高临床疗效。

Objective：To probe the therapeutic effects of Butylphthalide Injection in the elderly patients with acute cerebral infarction（ACI）and its influence in cerebral hemodynamics and cerebral vascular reserve（CVR）,and to clarify the pharmacological action mechanism of butylphthalide in treatment of ACI.Methods：A total of100 cases of elderly patients with ACI were selected as the subjects and divided into observation group and control group according to the serial number on admission.Fifty cases were included in each group.The patients in control group were treated with the conventional treatment,while the patients in observation group were treated with Butylphthalide Injection on the basis of the conventional treatment.The National Institute of Health Stroke Scale（NIHSS）score,the brain hemodynamics indexes of the peak velocity（Vp）,the mean velocity（Vm）and the differences of the velocity（DVp,DVm）as well as pulsatility index（PI）,CVR of bilateral middle cerebral artery（MCA）of the patients in two groups were observed and compared.The therapeutic effects of the patients in two groups were evaluated and compared.Results：The NIHSS score of the patients in observation group after treatment was significantly lower than that in control group（t=15.420,P〈0.05）.The therapeutic effects and the clinical efficiency of the patients in observation group were significantly better than those in control group（U=2.225,χ^2=5.005,P〈0.05）.The Vp and Vm of the patients in observation group after treatment were significantly higher than those in control group（t=10.819,t=7.259,P〈0.05）and the DVp and DVm were significantly lower than those in control group（t=16.438,t=19.055,P〈0.05）.The CVR of the patients in observation group after treatment was significantly higher than that in control group（t=6.884,P〈0.05）and the PI was significantly lower than that in control group（t=4.979,P〈0.05）.Conclusion：Butylphthalide Injection can effectively correct the abnormality of brain hemodynamics in the ACI patients,enhance the ability of body in maintaining the stability of cerebral vascular perfusion,improve the neurological symptoms in the patients with ACI,and improve the therapeutic effects.