依达拉奉联合丁苯酞对急性脑梗死患者的影响研究

Impact of Edaravone Combined with Butyphthalide on Patients with Acute Cerebral Infarction

目的探讨依达拉奉联合丁苯酞对急性脑梗死患者的影响。方法选取2016年3月—2017年8月沧州市盐山县人民医院收治的急性脑梗死患者106例,采用随机数字表法分为对照组52例和观察组54例。在常规治疗基础上,对照组患者给予依达拉奉治疗,观察组患者给予依达拉奉联合丁苯酞治疗;两组患者均连续治疗14 d。比较两组患者治疗前后血清基质金属蛋白酶9(MMP-9)、内皮素1(ET-1)、血管内皮细胞生长因子(VEGF)水平,治疗前、治疗结束时、随访3个月美国国立卫生研究院卒中量表(NIHSS)评分、功能独立性量表(FIM)评分,并观察两组患者治疗期间不良反应发生情况。结果治疗前两组患者血清MMP-9、ET-1、VEGF水平比较,差异无统计学意义(P>0.05);治疗后观察组患者血清MMP-9、ET-1水平低于对照组,血清VEGF水平高于对照组(P<0.05)。治疗前两组患者NIHSS评分、FIM评分比较,差异无统计学意义(P>0.05);治疗结束时、随访3个月观察组患者NIHSS评分低于对照组,FIM评分高于对照组(P<0.05)。两组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论依达拉奉联合丁苯酞可有效降低急性脑梗死患者血清MMP-9、ET-1水平,升高血清VEGF水平,改善神经功能及日常生活活动能力,且安全性较高。

Objective To investigate the impact of edaravone combined with butyphthalide on patients with acute cerebral infarction. Methods From March 2016 to August 2017, a total of 106 patients with acute cerebral infarction were selected in the People＇s Hospital of Yanshan County, Cangzhou, and they were divided into control group（n=52） and observation group（n=54） according to random number table. Based on conventional treatment, patients in control group received edaravone, while patients in observation group received edaravone combined with butyphthalide; both groups continuously treated for 14 days. Serum levels of MMP-9, ET-1 and VEGF before and after treatment, NIHSS score and FIM score before treatment, at the end of treatment and 3 months after follow-up were compared between the two groups, and incidence of adverse reactions was observed during treatment. Results No statistically significant differences of serum level of MMP-9, ET-1 or VEGF was found between the two groups before treatment（P〉0.05）; after treatment, serum levels of MMP-9 and ET-1 in observation group were statistically significantly lower than those in control group, while serum VEGF level in observation group was statistically significantly higher than that in control group（P〈0.05）. No statistically significant differences of NIHSS score or FIM score was found between the two groups before treatment（P〉0.05）; at the end of treatment and 3 months after follow-up, NIHSS score in observation group was statistically significantly lower than that in control group, respectively, while FIM score in observation group was statistically significantly higher than that in control group, respectively（P〈0.05）. No statistically significant differences of incidence of adverse reactions was found between the two groups during treatment（P〉0.05）. Conclusion Edaravone combined with butyphthalide can effectively reduce the serum levels of MMP-9 and ET-1 in patients with acute cerebral infarction, increase the serum VEGF level, improve the neurological function and activities of daily living, with relatively high safety.