丁苯酞对脑白质疏松患者大脑中动脉血流速度和外周血内皮微粒的作用

Effects of butylphthalide on the middle cerebral artery flow velocity and peripheral blood endothelial microparticles in patients with leukoaraiosis

目的探讨丁苯酞对脑白质疏松(LA)患者大脑中动脉血流速度和外周血内皮微粒(CD31^+/CD42b^-、CD144^+、CD62E^+)的作用。方法收集我院LA患者,其中轻度LA1组58例,中度LA2组30例,重度LA3组15例;收集同期健康体检为非脑白质疏松者NLA组50例;按随机数字表法将各组随机分为对照组和丁苯酞组。对照组给予常规治疗,丁苯酞组在常规治疗+丁苯酞软胶囊0.2 g口服,每日3次,治疗疗程为12 w。各组均于治疗前后测定大脑中动脉平均流速(Vm)、收缩期峰值流速(Vs)、和博动指数(PI);流式细胞仪检测外周血内皮细胞微粒CD31+/CD42b-、CD144+、CD62E+的表达百分率。结果 LA2、LA3组的各组12 w后较入组时Vs、Vm增快,PI值降低(P<0.05),丁苯酞组较对照组变化更明显(P<0.05);LA各组12 w后较入组时CD31^+/CD42b^-、CD144^+表达下降,CD62E^+表达升高(P<0.05),丁苯酞组较对照组变化更明显(P<0.05)。结论丁苯酞软胶囊可改善脑白质疏松患者脑血流情况,外周血内皮细胞微粒可早期反应脑血管的内皮调节功能,有望成为一种评估脑微血管血流情况的重要指标。

Objective To investigate the butylphthalide on leukoaraiosis（LA） artery blood flow velocity and peripheral blood endothelial microparticles in patients with brain（CD31~＋/CD42b^-,CD144~＋,CD62E~＋） role.Methods LA patients in our hospital,including 58 cases of mild LA1 group,moderate LA2 group 30 cases,15 cases of severe LA3 group;collecting healthy non leukoaraiosis group NLA 50 cases;were randomly divided into control group and butylphthalide group.The control group was given conventional treatment,and the butylphthalide group was treated with conventional treatment ＋ Butylphthalide Soft Capsules 0.2 g orally,3 times a day,with a course of treatment of 12 w.Each group were measured before and after treatment in the middle cerebral artery mean flow velocity（Vm）,peak systolic velocity（Vs）,and the pulsatile index（PI）;flow cytometry was used to detect the expression of peripheral blood endothelial microparticles CD31~＋/CD42b^-,CD144~＋,CD62E~＋.Results LA2 and LA3 groups were 12 w than groups Vs and Vm increased,PI decreased（P〈0.05）,butylphthalide group than in the control group changes more obviously（P〈0.05）.LA group 12 w compared with group CD31~＋/CD42b^-,CD144~＋ expression decreased,CD62E~＋ expression increased（P〈0.05）,the Ding Bentai group than in the control group changes more obviously（P〈0.05）.Conclusion Butylphthalide Soft Capsules can improve brain white matter in patients with cerebral blood flow,peripheral blood EMPs early response to cerebral vascular endothelial function,is expected to become an important index for evaluation of cerebral microvascular blood flow.