超早期应用丁苯酞对急性脑梗死患者的影响

Effect of Ultra-early Application of Butylphthalide in Patients with Acute Cerebral Infarction

目的探讨超早期应用丁苯酞治疗急性脑梗死(ACI)患者的效果。方法选取2018年12月至2021年12月郑州大学附属郑州中心医院收治的156例ACI患者为研究对象,按治疗方案分成两组,即观察组和对照组。在6 h内,所有患者均接受常规治疗措施,其中对照组78例患者接受依达拉奉治疗,观察组78例患者接受依达拉奉联合超早期丁苯酞治疗。观察两组患者的治疗总有效率、不良反应。比较两组治疗前后神经功能缺损程度评分(NIHSS)、日常生活能力(ADL)量表评分、骨保护素(OPG)、同型半胱氨酸(Hcy)水平、脑血流变化情况。结果观察组总有效率高于对照组(P<0.05)。治疗后,两组大脑中动脉、基底动脉的流速升高,观察组大脑中动脉、基底动脉的流速高于对照组(P<0.05)。治疗后,两组OPG、Hcy水平降低,观察组OPG、Hcy水平低于对照组(P<0.05)。治疗后,两组NIHSS评分呈现降低趋势,ADL评分呈现增高趋势,且观察组NIHSS较对照组低,ADL较对照组高(P<0.05)。不良反应组间差异无统计学意义(P>0.05)。结论超早期应用丁苯酞治疗ACI可提高治疗的整体效率,改善脑血流情况,减轻神经功能缺损程度,下调Hcy、OPG等指标水平。

Objective To explore the therapeutic effect of butylphthalide on patients with acute cerebral infarction(ACI)in the ultra-early stage.Methods A total of 156 ACI patients admitted to Zhengzhou Central Hospital of Zhengzhou University from December 2018 to December 2021 were selected as the study subjects and divided into two groups by treating methods,namely observation group and control group.Within 6 hours,all patients received routine treatment measures,and 78 patients in the control group received edaravone and 78 patients in the observation group received edaravone and super-early butylphthalide.The total treatment response rate and adverse effects in both groups were observed.The degree of neurological deficit score(NIHSS),activity of daily living(ADL)scale score,osteoprotectin(OPG),homocysteine(Hcy)levels,and changes in cerebral blood flow were compared between the two groups.Results The total effective rate of observation group was higher than that of control group(P<0.05).After treatment,the flow rates of middle cerebral artery and basilar artery in the two groups increased,and those in observation group were higher than those in control group(P<0.05).After treatment,the levels of OPG and Hcy in the two groups decreased,and those in observation group were lower than those in control group(P<0.05).After treatment,the NIHSS scores of the two groups decreased and the ADL scores increased,and the NIHSS score in observation group was lower than that in control group,and ADL score was higher than that in control group(P<0.05).There was no statistical difference in adverse reactions between groups(P>0.05).Conclusion Ultra-early treatment of ACI with butylphthalide can improve the overall efficiency of treatment,improve cerebral blood flow,reduce the degree of neurological deficit,and down-regulate Hcy,OPG and other indicators.