丁苯酞序贯治疗对急性脑梗死患者氧化应激相关指标的效果观察

Therapeutic effects of butylphthalide sequential therapy on acute cerebral infarction

目的观察丁苯酞注射液联合丁苯酞胶囊序贯治疗急性脑梗死的临床疗效及血超氧化物歧化酶(SOD)和丙二醛(MDA)的变化。方法选取2018年10月至2019年10月收治的急性脑梗死患者168例,随机分为丁苯酞序贯治疗组,丁苯酞注射液组和常规治疗组,每组56例。丁苯酞序贯治疗组为在常规治疗基础上给予丁苯酞注射液静脉滴注14 d,后丁苯酞胶囊口服至90 d;丁苯酞注射液组为在常规治疗基础上给予丁苯酞注射液静脉滴注14 d;常规治疗组急性期给予抗血小板聚集,降脂固斑等治疗后正规二级预防。于首诊、14 d、90 d评测3组美国国立卫生研究院卒中量表(NIHSS评分)、日常生活能力评分(ADL评分)、改良Rankin量表(mRS)评分及血浆氧化应激指标SOD和MDA水平。评定3组安全性及不良反应发生率。结果90 d时临床总有效率丁苯酞序贯治疗组(98.21%)显著高于常规治疗组(89.29%)(P<0.05);90 d时NHISS评分、mRS评分丁苯酞序贯治疗组显著低于丁苯酞注射液组和常规治疗组(P<0.05),ADL评分丁苯酞序贯治疗组显著高于丁苯酞注射液组和常规治疗组(P<0.05),MDA水平丁苯酞序贯治疗组显著低于丁苯酞注射液组和常规治疗组(P<0.05),SOD活性丁苯酞序贯治疗组显著高于丁苯酞治疗组和常规治疗组(P<0.05)。3组安全性及不良反应发生率差异无统计学意义(P>0.05)。结论丁苯酞序贯治疗90 d可有效改善患者神经功能及预后,减轻体内氧化应激反应,且比较安全可靠。

Objective To investigate the therapeutic effects of butylphthalide sequential therapy on acute cerebral infarction,and to observe the changes of superoxide dismutase(SOD)and malondiadehyde(MDA).Methods A total of 168 patients with acute cerebral infarction who were treated in our hospital were enrolled in the study,who were randomly divided into observation group,butylphthalide injection group and control group,with 56 cases in each group.The patients in observation group,on the basis of routine treatment,were treated by intravenous guttae with butylphthalide injection for 14 days,then were treated by oral butylphthalide capsules for 76 days,and the patients in butylphthalide injection group,on the basis of routine treatment,were treated by intravenous guttae with butylphthalide injection for 14 days,moreover,the patients in control group were treated by anti-platelet aggregation,lipid-lowering and plaque-reducing therapy.The National Institutes of Health Stroke Scale(NIHSS score),activities of daily living(ADL score)and modified rankin scale(mRS)were used to evaluate the curative effects.And the levels of SOD and MDA,and the safety as well as the incidence of adverse reactions were observed and compared among the three groups.Results After 90-day treatment,the total effective rate in observation group was 98.00%,which was significantly higher than that(89.00%)in control group(P<0.05),and the NHISS scores,mRS scores and MDA levels were significantly lower than those in butylphthalide injection group and control group,however,the ADL scores and the SOD levels were significantly higher than those in butylphthalide injection group and control group(P<0.05).There were no significant differences in safety and the incidence rates of adverse reactions among the three groups(P>0.05).Conclusion The butylphthalide sequential therapy for 90 days can effectively improve the neurological function and prognosis of patients with acute cerebral infarction,which can decrease the oxidative stress reactions of patients,with safety and reliability.