丹参酮Ⅱ_A磺酸钠注射液治疗急性脑梗死的临床研究

Clinical Study on Tanshinone Ⅱ_A Sodium Sulfonate Injection in the Treatment of Acute Cerebral Infarction

目的:探讨丹参酮Ⅱ_A磺酸钠注射液对急性脑梗死患者血清P-选择素、胶质纤维酸性蛋白(GFAP)和血管内皮生长因子(VEGF)及神经功能的影响。方法:选择2013年4月-2016年4月连云港市第一人民医院收治的急性脑梗死患者114例,按随机数字表法分为对照组与观察组,各57例。对照组患者给予常规治疗;观察组患者在对照组基础上加用丹参酮Ⅱ_A磺酸钠注射液40mg加入0.9%氯化钠注射液250 mL中,ivgtt,qd。7 d为1个疗程,两组均治疗2个疗程。比较两组患者治疗前和治疗7、14 d时的美国国立卫生院卒中量表(NIHSS)评分,血清P-选择素、GFAP和VEGF水平,以及不良反应发生情况。结果:治疗前,两组患者上述各项指标比较,差异均无统计学意义(P>0.05);与治疗前比较,两组患者治疗7、14 d时的NIHSS评分、血清P-选择素和GFAP水平均明显下降,血清VEGF水平明显上升,且治疗14 d时指标水平(NIHSS评分除外)均明显优于同组治疗7 d时,观察组指标水平均明显优于同期对照组,差异均有统计学意义(P<0.05)。两组患者均未见明显不良反应发生。结论:丹参酮Ⅱ_A磺酸钠注射液能显著降低急性脑梗死患者血清P-选择素和GFAP水平,提高VEGF水平,促进神经缺损功能恢复,且安全性较高。

OBJECTIVE： To investigate the effects of Tanshinone ⅡA sodium sulfonate injection on levels of P-selectin, glial fi- brillary acidic protein （GFAP）, vascular endothelial growth factor （VEGF） and neurological ftmction in patients with acute cere- bral infarction. METHODS： A total of 114 patients with acute cerebral infarction selected from Lianyungang First People＇s Hospi- tal during Apr. 2013-Apr. 2016 were divided into control group and observation group according to random number table, with 57 cases in each group. Control group was given routine treatment. Observation group was additionally given Tanshinone ⅡA sodium sulfonate injection 40 mg 0.9% sodium chlonride injection 250 mL, ivgtt, qd. A treatment course lasted for 7 d, and both received 2 courses of treatment. NIHSS scores, the levels of serum P-selectin, GFAP and VEGF were compared between 2 groups before treatment and after 7, 14 d of treatment. The occurrence of ADR was also compared. RESULTS： Before treatment, there was no statistical significance in above indexes between 2 groups （P〉0.05）. Compared to before treatment, NIHSS score, the levels of se- rum P-selectin and GFAP in 2 groups were decreased significantly after 7, 14 d of treatment, while the serum level of VEGF was increased significantly. These indexes of 2 groups after 14 d of treatment were significantly better than 7 d of treatment, except for NIHSS score. Above indexes of observation group was significantly better than those of control group during corresponding period, with statistical significance （P〈0.05）. No obvious ADR was found in 2 groups. CONCLUSIONS： For acute cerebral infarction, Tanshinone ⅡA sodium sulfonate injection can significantly reduce the levels of serum P-selectin and GFAP, improve VEGF level and promote the recovery of neurological damage with good safety.