丁苯酞联合巴曲酶治疗进展性急性脑梗死患者效果及作用机制

Effects of of butylphthalide combined with batroxobin in treatment of progressive ACI

目的探讨采用丁苯酞联合巴曲酶治疗进展性急性脑梗死(ACI)患者的效果及其作用机制。方法选取进展性急性脑梗死患者120例,采用随机数字表分为联合组和对照组,每组60例。联合组采用基础治疗+丁苯酞+巴曲酶治疗,对照组采用基础治疗+丁苯酞治疗;比较2组患者治疗前后神经功能缺损评分(NIHSS)、缺血低灌注区面积、血浆纤维蛋白原(Fib)、血小板聚集率、血浆粘度、血清脑源性神经生长因子(BDNF)、S100B蛋白、胱抑素C的变化。结果治疗前,联合组和对照组缺血低灌注区面积差异无统计学意义(P>0.05);联合组治疗后缺血低灌注区面积低于对照组(P<0.05);治疗前,联合组和对照组NIHSS评分差异无统计学意义(P>0.05);联合组治疗后NIHSS评分低于对照组(P<0.05);治疗前,联合组和对照组Fib、血小板聚集率、血浆粘度测定值差异无统计学意义(P>0.05);联合组治疗后Fib、血小板聚集率、血浆粘度测定值低于对照组(P<0.05);治疗前,联合组和对照组血清BDNF、S100B蛋白、Cys-C差异无统计学意义(P>0.05);联合组治疗后血清S100B蛋白、Cys-C低于对照组(P<0.05)。结论丁苯酞联合巴曲酶治疗进展性急性脑梗死患者有利于快速改善脑缺血灌注水平、改善纤溶及血浆粘度水平,有助于早期患者神经功能的恢复。

Objective To investigate the effects and action mechanism of butylphthalide combined with batroxobin in treatment of progressive acute cerebral infarction(ACI).Methods A total of 120 patients with progressive ACI who were treated in our hospital were enrolled in the study,who were randomly divided into combination treatment group and control group,with 60 cases in each group.The patients in combination treatment group were treated by basic treatment+butylphthalide+batroxobin,however,the patients in control group were treated by basic treatment+styrene butadiene.The NIHSS score,ischemic hypoperfusion area,plasma fibrinogen(Fib),platelet aggregation rate,plasma viscosity,serum brain derived nerve growth factor(BDNF),S100B protein,cystatin C were observed and compared between the two groups.Results Before treatment,there was no significant difference in the area of ischemic hypoperfusion between the two groups(P>0.05).After treatment,the area of ischemic hypoperfusion in combination treatment group was significantly lower than that in control group(P<0.05).Before treatment,there were no significant differences in NIHSS scores between the two groups(P>0.05).After treatment the NIHSS scores in combination treatment group were significantly lower than those in control group(P<0.05).Before treatment there were no significant differences in Fib,platelet aggregation rate and plasma viscosity before the two groups(P>0.05).After treatment,the Fib,platelet aggregation rate,and plasma viscosity in combination treatment group were significantly lower than those in control group(P<0.05).Before treatment,there were no significant differences in BDNF,S100B protein and Cys C(P>0.05),after treatment,the serum S100B protein and Cys C in combination treatment group were significantly lower than those in control group(P<0.05).Conclusion Butylphthalide combined with batroxobin in treatment of progressive ACI is beneficial for improving cerebral ischemia perfusion levels,fibrinolysis and plasma viscosity levels rapidly,which is helpful for the early neurological function recovery of patients.