丁苯酞治疗进展性脑梗死患者疗效及对血清白细胞介素6和S100B蛋白表达的影响

The effects of butylphthalide on patients with progressive infarction and the serum IL-6 and protein expression of S100B

目的:观察丁苯酞氯化钠注射液对进展性脑梗死患者疗效及对血清白细胞介素(IL-6)、S100B蛋白的影响。方法:选取进展性脑梗死患者93例,随机分为对照组和丁苯酞组,选取正常体检者45例,(脑梗死患者均给予常规治疗,丁苯酞组在常规治疗基础上加用丁苯酞氯化钠注射液100 m L,静滴,bid,连续用药14 d)。采用ELISA法检测患者首诊时、进展后和治疗后14,30,90 d的血清IL-6和S100B水平,比较其含量的差异;比较两组脑梗死患者进展后及治疗后14,30,90 d的NIHSS评分和Barthel指数,治疗90 d的mRS评分以及不良反应发生情况。结果:两组患者进展后IL-6,S100B及NIHSS评分、Bathel指数比较,差异均无统计学意义(P> 0. 05);脑梗死组患者进展后IL-6及S100B水平高于首诊时,差异有统计学意义(P <0. 05);丁苯酞组治疗后14,30,90 d血清IL-6及S100B水平均较对照组有所下降,差异有统计学意义(P <0. 05);两组治疗后14,30,90 d NIHSS评分均低于进展后,Bathel指数评分高于进展后,丁苯酞组NIHSS评分降低率均大于对照组,90 d mRS评分低于对照组,差异有统计学意义(P <0. 05);两组均无严重不良反应发生。结论:脑梗死进展与血清IL-6和S100B的高表达有关,丁苯酞可能通过减少血清IL-6和S100B的高表达,从而改善患者的神经功能。

Objective:To observe the efficacy of butylphthalide on patients with progressive infarction and the effect on serum IL-6 and the protein expression of S100 B.Methods:Ninety-three patients with progressive infarction were randomly divided into butylphthalide group and control group.Other forty-five healthy subjects were selected.The patients in control group were given general treatment,while the patients in butylphthalide group were injected with butylphthalide in addition to general treatment for 14 days.The expression level of serum IL-6 and S100 B in each group were detected by enzyme-linked immunosorbent assay at first diagnosis,after progress,and after 14,30,and 90 days treatment.The scores of NIHSS,Bathel index and the occurrence of adverse reactions of the patients in both groups were compared after progress,on the 14,30 and 90 days of treatment.Results:There was no significant difference between the two groups in IL-6,S100 B,NIHSS score and Bathel index afterprogression(P>0.05).The level of IL-6 and S100 B in cerebral infarction is lower than that after progress(P<0.05).The serum levels of IL-6 and S100 B at 14,30 and 90 days after treatment were significantly lower in butylphthalide group than those in control group(P<0.05).The NIHSS scores of two groups for 14,30 and 90 days after treatment were lower than those after progress.The Bathel index score was higher than those after progress(P<0.05).The reduction rate of NIHSS scores for 14 and 90 days after treatment in butylphthalide group were higher than those in control group(P<0.05).There were no serious adverse reactions occurred in b groups.Conclusion:The progression of cerebral infarction is related to the high expression of serum IL-6 and S100 B.Butylphthalide may improve the neurological function of patients by reducing the high expression of serum IL-6 and S100 B.