丁基苯酞联合巴曲酶治疗急性缺血性脑梗死疗效及对临床指标的影响

The efficacy of butylphthalide combined with batroxobin in the treatment of patients with acute ischemic cerebral infarction and its influence on clinical indexes

目的探讨丁基苯酞(NBP)联合巴曲酶治疗急性缺血性脑梗死(AIS)疗效及对血清低氧诱导因子1α(HIF-1α)、S-100B、神经元特异性烯醇化酶(NSE)水平、脑梗死面积和神经功能的影响。方法我院收治的115例AIS患者,按随机数表法分为观察组(NBP联合巴曲酶治疗)58例和对照组(巴曲酶治疗)57例。比较两组治疗效果,治疗前及治疗2周后脑梗死面积、神经功能[美国国立卫生研究院卒中量表(NHISS)]、认知功能[蒙特利尔认知评估量表(MoCA)]、疾病相关因子[HIF-1α、S-100B、NSE、视黄醇结合蛋白4(RBP4)]水平,治疗期间不良反应发生情况。结果治疗2周后,两组有效率比较差异无统计学意义(P>0.05)。观察组脑梗死面积、NHISS、疾病相关因子(HIF-1α、S-100B、NSE、RBP4)水平均低于治疗前及对照组,MoCA评分高于治疗前及对照组(P<0.05)。结论NBP联合巴曲酶治疗AIS具有显著疗效,能够降低患者脑梗死面积及血清HIF-1α、S-100B、NSE水平,改善神经功能及认知功能。

Objective To investigate the efficacy of butylphthalide(NBP)combined with batroxobin in the treatment of patients with acute ischemic cerebral infarction(AIS)and its effects on levels of serum hypoxia-inducible factor 1α(HIF-1α),S-100B and neuron-specific enolase(NSE),cerebral infarction area and neurological impairment score.Methods One hundred and fifteen patients with AISadmitted to our hospital were randomly divided into observation group(NBP combined with batroxobin treatment,n=58)and control group(batroxobin treatment,n=57).The treatment effects were compared between the two groups.The cerebralinfarction area,neurological function estimated with National Institutes of Health Stroke Scale(NHISS),cognitive function estimated with Montreal Cognitive Assessment Scale(MoCA)and levels of disease-related factors such as HIF-1α,S-100B,NSE and retinol binding protein 4(RBP4)were compared between the two groups before and after 2 weeks of treatment.The occurrence of adverse reactions during treatment wasobserved in the two groups.Results After 2 weeks of treatment,there was no statistically significant difference in the effective rate between the two groups(P>0.05).After 2 weeks of treatment,thecerebral infarction area,NHISS score and levels of disease-related factorsof the observation group were significantly lower than thosebefore treatment and those of the control group during the same period while the MoCA scores were significantly higher than those before treatment and those of control group during the same period(P<0.05).Conclusion NBP combined with batroxobin has a significant efficacy in the treatment of AIS.It can reduce the cerebral infarction area and levels of serum HIF-1α,S-100B and NSEand improve the neurological and cognitive functions.