丹参注射液治疗缺血性脑卒中疗效及对患者LPA、TLR4水平、神经功能影响的研究

Effect of slvia miltiorrhiza injection on LPA,TLR4 and nerve function in patients with ischemic stroke

目的:探讨丹参注射液治疗缺血性脑卒中的疗效及对患者血浆LPA水平、外周单核细胞表面TLR4表达、神经功能的影响。方法:选取缺血性脑卒中患者100例,随机分为观察组和对照组,每组50例。对照组患者给予丁苯酞注射液治疗,观察组患者在此基础上加用复方丹参注射液治疗。比较两组患者治疗后血浆LPA水平、外周单核细胞表面TLR4表达、神经功能缺损及BI与FMA评分。结果:两组患者15d内血浆LPA水平呈先升后降的趋势;观察组与对照组第7天分别为(2.55±0.82)μmol/L,(3.67±0.93)μmol/L与第1天(1.85±0.57)μmol/L,(1.86±0.29)μmol/L比较,LPA水平上升。两组第15天LPA水平均下降,观察组(1.08±0.83)μmol/L明显低于对照组(1.69±0.14)μmol/L,差异有统计学意义(P<0.05)。两组患者15d内外周单核细胞表面TLR4表达不断下降,且观察组(18.48±6.86)mg/L明显低于对照组(24.61±10.58)mg/L,差异有统计学意义(P<0.05)。治疗后两组患者神经功能缺损评分均低于治疗前,且观察组(10.75±3.97)分明显低于对照组(17.52±4.94)分,差异有统计学意义(P<0.05)。与治疗前相比,治疗后观察组与对照组BI和FMA评分均明显升高,且观察组分别为(67.36±8.48)分、(50.63±7.76)分明显高于对照组(52.62±7.57)分、(36.47±5.45)分,差异均有统计学意义(P<0.05)。结论:复方丹参注射液治疗缺血性脑卒中可有效降低LPA、TLR4水平,改善患者的临床症状和神经功能,并提高日常活动能力,临床效果显著。

Objective ：Effect of salvia miltiorrhiza injection in the treatment of ischemic stroke and its effect on plasma LPA level, TLR4 expression of peripheral monocyte surface and nerve function were investigated. Methods ：100 patients with ischemic stroke admitted to our hospital were randomly divided into the observation group and the control group, 50 cases in each group. The control group was treated with butylphthalide injection, and the observation group was treated with compound salvia miltiorrhiza injection on this basis. Plasma LPA level, TLR4 expression on peripheral mononuclear cells, neurological deficit and BI and FMA scores were compared between the two groups after treatment. Results： The plasma LPA level of the two groups increased first and then decreased within 15 days, LPA level of the observation group and the control group rised on the 7th day （2.55±0.82）μmol/L,（3.67±0.93μ）mol/L,comparing with the first day（1.85±0.57）μmol/L,（1.86±0.29）μmol/L.LPA levels in both groups decreased on the 15th day,The observation group（1.08±0.83）μmol/L was significantly lower than the control group（1.69±0.14）μmol/L. The difference was statistically significant （ P 〈0.05）. The expression of TLR4 on the surface of peripheral mononuclear cells in the two groups decreased continuously within 15 days, and the expression of TLR4 in the observation group（18.48±6.86）mg/L was significantly lower than that in the control group（24.61±10.58）mg/L.The difference was statistically significant （ P 〈0.05）. After treatment, the neurological deficit scores of the two groups were lower than those before treatment, and the observation group （10.75±3.97）was significantly lower than the control group （17.52±4.94）,the difference was statistically significant （ P 〈0.05）. Compared with before treatment, the BI and FMA scores of the observation group and the control group were significantly higher after treatment, and the observation group （67.36±8.48）,（50.63±7.76） was significantly higher than the control group （52.62±7.57）,（36.47±5.45）, the difference was statistically significant （ P 〈0.05）. Conclusion ： Compound salvia miltiorrhiza injection can effectively reduce the level of LPA and TLR4, improve the clinical symptoms and nerve function of the patients, and improve the ability of daily activity. The clinical effect is remarkable.