高压氧辅助丁苯酞治疗急性缺血性脑卒中患者的疗效及对血清ET-1、TXB2及VEGF水平的影响

Curative effect of hyperbaric oxygen assisted butylphthalide patients with acute ischemic stroke and their influence on serum ET-1,TXB2 and VEGF levels

目的探讨高压氧辅助丁苯酞对急性缺血性脑卒中患者疗效及血清内皮素-1(ET-1)、血栓素B2(TXB2)及血管内皮生长因子(VEGF)水平的影响。方法选取2016年6月至2018年6月在山西省人民医院就诊的284例急性缺血性脑卒中患者,按入院顺序随机分为2组,每组142例。对照组采用丁苯酞治疗,联合组采用高压氧辅助丁苯酞治疗,治疗时间均为14 d。对比2组患者的美国国立卫生院卒中量表(NIHSS)评分和Barthel指数评分,临床疗效,血清ET-1、TXB2和VEGF水平,凝血功能,血液流变学指标以及不良反应。结果治疗后2组患者NIHSS评分较治疗前均降低,且联合组NIHSS评分低于对照组,治疗后2组Barthel指数评分均高于治疗前,且联合组Barthel指数高于对照组,差异均有统计学意义(P<0.05);治疗后2组疗效等级分布比较差异显著,且联合组的总有效率(95.77%)高于对照组(88.03%),差异有统计学意义(χ^(2)=5.724,P<0.05);治疗后2组患者血清ET-1、TXB2水平均低于治疗前,且联合组血清ET-1、TXB2水平均低于对照组,治疗后2组VEGF水平较治疗前均升高,且联合组VEGF水平高于对照组,差异均有统计学意义(P<0.05);治疗后2组患者凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)均长于治疗前,且联合组TT、PT、APTT均长于对照组,差异均有统计学意义(P<0.05);2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论高压氧辅助丁苯酞治疗急性缺血性脑卒中患者临床疗效显著,能够减轻血管内皮损伤,改善凝血功能和血液流变学,安全可靠。

Objective To explore the effects of hyperbaric oxygen-assisted butylphthalide on patients with acute ischemic stroke and the effects of serum endothelin-1(ET-1),thromboxane B2(TXB2)and vascular endothelial growth factor(VEGF)levels.Methods A total of with acute ischemic stroke were selected,and randomly divided into two groups(according to the order of admission).The control group was treated with butylphthalide,and the combined group was treated with hyperbaric oxygen-assisted butylphthalide,the treatment time was 14 days.The National Institutes of Health Stroke Scale(NIHSS)score and Barthel index score,clinical efficacy,serum ET-1,TXB2 and VEGF levels,coagulation function,hemorheology index,and adverse reactions between the two groups of patients were compared.Results Compared with before treatment,the NIHSS scores of the two groups of patients were significantly reduced after treatment(P<0.05),and the NIHSS scores of the combined group after treatment were significantly lower than those of the control group(P<0.05).After treatment,the Barthel index scores of the two groups were significantly higher than those before treatment(P<0.05),and after treatment,compared with the control group,the combination group had significantly higher Barthel index(P<0.05).After treatment,there was a significant difference in the distribution of curative effects between the two groups,and compared with the control group(88.03%),the total effective rate of combined group(95.77%)was significantly higher(χ^(2)=5.724,P<0.05).Compared with before treatment,serum ET-1 and TXB2 levels of the two groups were significantly lower after treatment,compared with the control group,the serum ET-1 and TXB2 levels of combination group were significantly lower,the VEGF levels of the two groups were significantly higher than before treatment,and compared with the control group,the combination group had significantly higher VEGF levels(P<0.05).Compared with before treatment,thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT)in both groups were higher after treatment,and the TT,PT,and APTT of the combination group were significantly higher than those of control group(P<0.05).There were no statistically significant difference in incidence of adverse reactions between the two groups(P>0.05).Conclusion Hyperbaric oxygen-assisted butylphthalide has a significant clinical effect on the treatment of patients with acute ischemic stroke,and reduce vascular endothelial damage,improve blood coagulation function and hemorheology,and it is safe and reliable.