丁苯酞治疗对脑梗死伴大脑中动脉严重狭窄患者责任动脉血流的影响

Effect of butylphthalide on responsible arterial blood flow in patients with cerebral infarction accompanied with severe stenosis of middle cerebral artery

目的探讨丁苯酞治疗对脑梗死伴大脑中动脉严重狭窄患者责任动脉血流的影响。方法选取2016年10月至2018年10月我院收治的脑梗死伴大脑中动脉严重狭窄患者80例作为研究对象。两组患者均给予常规药物治疗,在此基础上加用丁苯酞治疗的患者40例,设为观察组;因存在丁苯酞使用禁忌证而未给予丁苯酞治疗的患者40例,设为对照组。两组患者均连续治疗10 d。比较两组患者治疗前后MRI显示的病灶侧责任动脉相对局部脑血流量(rCBF)、相对局部脑血容量(rCBV)、相对局部平均通过时间(rMTT)、相对局部峰值时间(rTTP)和神经功能缺损评分(NIHSS)。结果治疗前,两组患者病灶侧责任动脉rCBF、rCBV、rMTT以及rTTP水平比较,差异无统计学意义(P>0.05)。治疗10 d后,两组患者的rCBF、rCBV水平均显著升高,rMTT、rTTP水平均显著降低,观察组的rCBF、rCBV水平显著高于对照组,rMTT、rTTP水平显著低于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者的NIHSS评分比较差异无统计学意义(P>0.05);治疗10 d后,两组患者的NIHSS评分均显著降低,观察组患者的NIHSS评分明显低于对照组,差异有统计学意义(P<0.05)。结论在常规药物治疗的基础上加用丁苯酞注射液治疗,可明显改善急性脑梗死伴大脑中动脉严重狭窄患者的脑血流供应状况,有效改善患者的神经功能。

Objective To investigate the effect of butylphthalide on blood flow of responsible arteries in patients with cerebral infarction accompanied with severe stenosis of middle cerebral artery. Methods Eighty patients with cerebral infarction and severe stenosis of middle cerebral artery admitted to our hospital from October 2016 to October 2018 were selected as the research subjects. Patients in both groups were administered routine medicine treatment, based on which 40 patients were additionally administered butylphthalide, and were assigned as observation group. Other 40 patients with the present of contraindication for the use of butylphthalide were not administered butylphthalide, and were assigned as control group. Patients in both groups were treated continuously for 10 days. The pre-and post-treatment relative local cerebral blood flow(rCBF), relative local cerebral blood volume(rCBV), relative local mean transit time(rMTT), relative time to peak(rTTP), and the National Institute of Health Stroke Scale(NIHSS) of the lesion-side responsible arteries exhibited by MRI in patients were compared between the two groups. Results Before treatment, there were no statistically significant differences in the rCBF, rCBV, rMTT and rTTP levels of the responsible arteries at the lesion side between the two groups(P>0.05). After 10 days of treatment, the levels of rCBF and rCBV in the two groups significantly increased, whereas the levels of rMTT and rTTP significantly decreased;in comparison with the control group, the observation group obtained significantly higher levels of rCBF and rCBV, while significantly lower levels of rMTT and rTTP, with the statistically significant differences(P<0.05). Before treatment, there was no statistically significant difference in NIHSS scores of patients between the two groups(P>0.05). After 10 days of treatment, the NIHSS scores of the two groups significantly decreased, and the NIHSS scores of the observation group were significantly lower than those of the control group, and the differences were statistically significant(P<0.05). Conclusion On the basis of routine medicine treatment, additionally employing butylphthalide injection can prominently improve the cerebral blood flow supply in patients with acute cerebral infarction accompanied with severe middle cerebral artery stenosis, and effectively improve the neurological function of patients.