丁苯酞注射液联合抗血小板药物治疗对轻型卒中的临床疗效及卒中复发风险影响的探究

Exploring the clinical effect of dl-3-N-butylphthalide(NBP)injection combined with antiplatelet drug therapy and the influence on stroke recurrence of minor stroke patients

目的探究丁苯酞注射液联合抗血小板药物治疗对轻型卒中的临床疗效及卒中复发风险影响。方法回顾性分析哈尔滨医科大学附属第二医院卒中中心2019年1月至7月收治的轻型卒中患者95例,其中联合治疗组(丁苯酞+抗血小板治疗组)45例,对照组(抗血小板治疗组)50例。分析两组患者治疗后14 d、1 m、3 m、6 m的mRS评分,NIHSS评分和BI。并统计治疗后1 m、3 m、6 m卒中复发情况。将可能影响轻型卒中复发的因素进行多因素分析。结果①治疗前两组患者基本资料无统计学差异(P>0.05),具有可比性。②两组治疗后14 d、1 m、3 m、6 m mRS评分,NIHSS评分和BI与治疗前相比均有显著差异(P<0.01)。③联合治疗组1 m、3 m、6 m mRS评分显著低于对照组,且差异有统计学意义(P值分别为0.033、0.031、0.013)。④联合治疗组3 m、6 m卒中复发人数显著低于对照组(P值分别为0.033、0.039)。⑤多因素回归分析结果显示:丁苯酞治疗是轻型卒中3 m(OR=0.060,95%CI 0.005~0.778,P=0.031)和6 m卒中复发的独立保护性因素(OR=0.163,95%CI 0.028~0.968,P=0.046)。结论丁苯酞注射液联合抗血小板药物治疗可以显著改善轻型卒中患者的神经功能,并降低卒中复发。

Objective To explore the clinical effect of dl-3-N-butylphthalide(NBP)injection combined with antiplatelet drug therapy and the influence on stroke recurrence of minor stroke patients.Methods A retrospective analysis was performed on 95 patients with minor stroke that admitted to the stoke center of the second affiliated hospital of Harbin Medical University from January to July 2019.It included 45 patients in the combined treatment group(NBP plus antiplatelet treatment group)and 50 patients in the control group(antiplatelet treatment group).The mRS score,NIHSS score and BI of the two groups were analyzed at 14 days,1 month,3 months and 6 months after treatment.The stroke recurrence events at 1 month,3 months,and 6 months after treatment in both groups will be recorded too.We used multivariate analysis to analyze the factors that might influence stroke recurrence in minor stroke patients.Results①There was no significant difference in baseline information between the two groups(P>0.05),which was comparable.②At 14 days,1 month,3 months and 6 months after treatment,the mRS scores and NIHSS scores of the patients in the two groups were significantly lower than that at admission,while the Barthel index were significantly higher than that at admission(P<0.01).③In the combined treatment group at 1 month,3 months and 6 months after treatment,the mRS scores were significantly lower than those in the control group(P=0.033,0.031,0.013).④The number of the combined treatment group patients with stroke recurrence at 3 months and 6 months after treatment was significantly lower than that in the control group(P=0.033,0.039).⑤The results of multivariate analysis showed that using NBP was an independent protective factor in stroke recurrence at 3 months(OR=0.060,95%CI 0.005~0.778,P=0.031)and 6 months(OR=0.163,95%CI 0.028~0.968,P=0.028)for minor stroke.Conclusion NBP combined with antiplatelet drugs can significantly improve the neurological function and reduce the stroke recurrence of minor stroke patients.