丁苯酞联合阿司匹林肠溶片治疗对老年缺血性脑卒中患者神经功能及神经递质水平的影响

Effects of butylphthalide combined with aspirin enteric-coated tablets on neurological function and neurotransmitter levels in elderly patients with ischemic stroke

目的观察丁苯酞联合阿司匹林肠溶片治疗对老年缺血性脑卒中患者神经功能及神经递质水平的影响。方法选取海南省儋州市人民医院神经内科2019年1月至2020年7月收治的100例老年缺血性脑卒中患者,按照随机数字表法分为对照组和观察组,各50例。对照组口服阿司匹林肠溶片治疗,观察组在对照组基础上加用丁苯酞注射液静脉滴注治疗,2组均连续治疗2周。分别比较2组临床疗效、美国国立卫生研究院卒中量表(NIHSS)评分、日常生活活动能力量表(ADL)评分、神经递质水平及不良反应。结果观察组临床有效率高于对照组[84.0%(42/50)比74.0%(37/50)],差异有统计学意义(χ^(2)=6.540,P=0.023)。与治疗前比较,治疗后2组NIHSS评分均明显降低,ADL评分均明显升高,且观察组改善程度明显优于对照组[(8.5±1.3)分比(10.8±3.2)分、(65±13)分比(53±11)分],差异均有统计学意义(均P<0.05)。与治疗前比较,治疗后2组血清天冬氨酸、谷氨酸水平明显降低,多巴胺、5-羟色胺水平均明显升高,且观察组改善程度明显优于对照组,差异均有统计学意义(均P<0.05)。观察组不良反应发生率低于对照组[8.0%(4/50)比12.0%(6/50)],差异有统计学意义(χ^(2)=2.000,P=0.045)。结论丁苯酞联合阿司匹林肠溶片治疗老年缺血性脑卒中患者能够调节神经递质水平,对神经功能缺损具有一定的改善及保护功能。

Objective To observe the effects of butylphthalide combined with aspirin enteric-coated tablets on the neurological function and neurotransmitter levels in elderly patients with ischemic stroke.Methods From January 2019 to July 2020,100 elderly patients with ischemic stroke admitted to Department of Neurology,Danzhou People’s Hospital,Hainan Province were selected.They were randomly divided into control group and observation group,with 50 cases in each group.The control group was treated with aspirin enteric-coated tablets orally,and the observation group was treated with butylphthalide injection intravenous drip on the basis of the control group.Both groups were treated for 2 weeks.The clinical efficacy,National Institutes of Health Stroke Scale(NIHSS)score,activity of daily living scale(ADL)score,neurotransmitter level and adverse reactions were compared between the two groups.Results The clinical effective rate of the observation group was higher than that of the control group[84.0%(42/50)vs 74.0%(37/50)],and the difference was statistically significant(χ^(2)=6.540,P=0.023).Compared with before treatment,NIHSS score and ADL score of the two groups significantly decreased after treatment,and those improvement degrees of the observation group were significantly better than those of the control group[(8.5±1.3)vs(10.8±3.2),(65±13)vs(53±11)](all P<0.05).Compared with before treatment,the serum levels of aspartic acid and glutamic acid of the two groups significantly decreased,dopamine and 5-hydroxytryptamine levels significantly increased,and those improvement degrees of the observation group were significantly better than those of the control group,and the differences were statistically significant(all P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group[8.0%(4/50)vs 12.0%(6/50)],and the difference was statistically significant(χ^(2)=2.000,P=0.045).Conclusion Butylphthalide combined with aspirin enteric-coated tablets in the treatment of elderly patients with ischemic stroke can regulate the level of neurotransmitter,and have certain improvement and protection function for neurological defects.