丁苯酞治疗急性缺血性脑卒中患者的疗效评价

Evaluation of Therapeutic Effect of Butylphthalide on Patients with Acute Ischemic Stroke

目的:探讨丁苯酞治疗急性缺血性脑卒中患者的临床疗效。方法:选取本院2018年7月-2019年6月收治的急性脑梗死患者96例,随机分为观察组和对照组,各48例。两组患者均进行抗血小板聚集、抗动脉硬化等常规治疗,观察组在常规治疗基础上口服丁苯酞软胶囊。比较两组患者的临床疗效及治疗前后血清同型半胱氨酸(Hcy)、水通道蛋白4(AQP4)、基质金属蛋白酶9(MMP-9)的水平和神经功能及认知功能变化情况,并记录治疗过程中不良反应的发生情况。结果:观察组治疗总有效率91.67%,显著高于对照组的75.00%(χ~2=4.800,P=0.028);与治疗前比较,治疗7、14、28 d后两组患者的NIHSS评分均显著降低,且观察组低于对照组,差异有统计学意义(P<0.05);与治疗前比较,治疗7、14、28 d后两组患者的MMSE评分均显著升高,且观察组高于对照组,差异有统计学意义(P<0.05);与治疗前比较,治疗28 d后两组患者血清Hcy、AQP4、MMP-9水平均显著降低,且观察组低于对照组,差异有统计学意义(P<0.05);两组患者治疗过程中不良反应发生率差异无统计学意义(P>0.05)。结论:丁苯酞治疗急性缺血性脑卒中安全有效,能明显降低患者血清Hcy、AQP4、MMP-9水平,改善患者神经功能和认知功能。

Objective To explore the clinical effect of butylphthalide on the treatment of patients with acute ischemic stroke. Methods 96 patients with acute cerebral infarction admitted in our hospital from July 2018 to June 2019 were randomly divided into observation group and control group, with 48 cases in each group. Two groups of patients were treated with routine therapy such as anti-platelet aggregation and anti-arteriosclerosis. The observation group was treated with butylphthalide soft capsule on the basis of routine therapy. The clinical effects, the levels of serum homocysteine(Hcy), aquaporin-4(AQP4), matrix metalloproteinase-9(MMP-9), the changes of neural function and cognitive function were compared between the two groups, and the occurrence of adverse reactions during the treatment was recorded. Results The total effective ratio in the observation group was 91.67%, which was significantly higher than 75.00% in the control group(91.67% vs 75.00%)(χ~2=4.800, P=0.028). Compared with those before treatment, the NIHSS scores of two groups were significantly decreased after treatment for 7 d, 14 d and 28 d, and the difference was statistically significant(P<0.05). Compared with the before treatment, the MMSE scores of the two groups were significantly higher after 7, 14 and 28 days of treatment, and the difference was statistically significant between the observation group and the control group(P<0.05). Compared with the pre-treatment, after 28 days of treatment, the serum Hcy, AQP4, MMP-9 levels in the two groups were significantly lower, and the difference was statistically significant(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups during the treatment process(P>0.05). Conclusion NBP is safe and effective in the treatment of acute ischemic stroke. It can significantly reduce the levels of Hcy, AQP4, MMP-9 in the serum of patients, improve patient′s neurological and cognitive functions.