丁苯酞治疗内囊预警综合征的临床疗效及其对影像学特征和预后的影响

Clinical efficacy of butylphthalide in the treatment of internal capsule warning syndrome and its influence on imaging features and prognosis

目的:探究丁苯酞治疗内囊预警综合征的临床疗效及其对影像学特征和预后的影响。方法:按照治疗方案不同将104例内囊预警综合征患者分为对照组及观察组,每组各52例。对照组采用双联抗血小板进行治疗,观察组在对照组的基础上加用丁苯酞治疗。观察两组患者治疗前后临床症状、神经功能及预后情况,并采用Spearman法进行相关性分析;同时采用二元Logistics回归分析影响预后的主要影响因素。结果:两组患者治疗3个月内出现颅内出血及系统性出血情况的比较,差异无统计学意义(P>0.05),但观察组不可逆神经损伤发生率低于对照组(P<0.05);治疗24 h、7 d、3个月,两组患者NIHSS评分均随时间而下降,且观察组低于对照组(P<0.05);观察组治疗3个月后,患者预后情况较对照组好(P<0.05);两组患者MRS与NIHSS评分均呈正相关(P<0.05);两组患者年龄、高血脂症、症状类型、责任血管颈内动脉狭窄程度及NIHSS评分所占比例相比,差异均有统计学意义(P<0.05);经多因素分析显示,年龄、高血脂症、症状类型、责任血管颈内动脉狭窄程度及NIHSS评分均为预后是否良好的主要影响因素。结论:丁苯酞治疗内囊预警综合征的临床疗效较好,且对于高龄及患高血脂症等患者,应采取针对性措施进行干预,以改善患者预后。

Objective:To explore the clinical efficacy of butylphthalide in the treatment of internal capsule warning syndrome and its influence on imaging characteristics and prognosis.Methods:A total of 104 patients with internal capsule warning syndrome were selected and divided into a control group and an observation group according to different treatment schemes,with 52 cases in each group.The control group was treated with dual antiplatelet therapy,and the observation group was additionally treated with butylphthalide on the basis of the control group.The clinical symptoms,neurological function and prognosis of the two groups before and after treatment were observed,and Spearman's method was used for correlation analysis,and binary Logistic regression was used to analyze the main influencing factors of prognosis.Results:There was no significant difference in intracranial hemorrhage and systemic hemorrhage between the two groups within 3 m of treatment(P>0.05),but the incidence of irreversible nerve damage in the observation group was lower than that in the control group(P<0.05).After 24 h,7 d and 3 m of treatment,the NIHSS scores of the two groups of patients decreased with time at different times,and the observation group was lower than the control group(P<0.05).After 3 m of treatment,the prognosis was better than that of the control group(P<0.05).MRS and NIHSS scores were positively correlated in both groups(P<0.05).There were differences in age,hyperlipidemia,symptom type,degree of internal carotid artery stenosis of the responsible vessel and the proportion of NIHSS score between the two groups(P<0.05).Tthe multivariate analysis showed that age,hyperlipidemia,symptom type,the degree of internal carotid artery stenosis of the responsible vessel and NIHSS score were the main influencing factors for good prognosis.Conclusion:Butylphthalide has a good clinical effect in the treatment of internal capsule early warning syndrome,and targeted measures should be taken for elderly patients and patients with hyperlipidemia in order to improve the prognosis of patients.