丁苯酞对脑梗死后脑水肿患者血清Hcy、AQP4、MMP-9水平和神经功能的影响

Effects of Butylphthalide on Serum Hcy,AQP4,MMP-9 Levels and Nerve Function in Patients with Cerebral Edema after Cerebral Infarction

目的:观察丁苯酞对脑梗死后脑水肿患者血清同型半胱氨酸(Hcy)、水通道蛋白4(AQP4)、基质金属蛋白酶-9(MMP-9)水平和神经功能的影响。方法:纳入上海市东方医院吉安医院2019年1月-2021年12月96例脑梗死后脑水肿患者,随机分为对照组(n=48,常规治疗方法)和观察组(n=48,对照组基础治疗上,丁苯酞胶囊口服治疗方法)。比较两组患者疗效、美国国立卫生研究所脑卒中评分(NIHSS)变化、简易精神状态评价量表(MMSE)评分变化、血清Hcy、AQP4、MMP-9变化及不良反应发生情况。结果:观察组总有效率91.67%,高于对照组的75.00%(P<0.05)。两组治疗前NIHSS评分、MMSE评分、Hcy、AQP4、MMP-9对比,差异均无统计学意义(P>0.05);治疗7、14、28 d,两组NIHSS评分均低于治疗前,MMSE评分均高于治疗前,两组治疗后Hcy、AQP4、MMP-9均低于治疗前,且观察组变化更显著,差异均有统计学意义(P<0.05);两组治疗不良反应发生情况对比,差异无统计学意义(P>0.05)。结论:丁苯酞能够有效控制Hcy、MMP-9、AQP4等水平,控制脑水肿的进一步发展,有效遏制脑组织损伤的情况发生,防止患者丧失神经及认知功能。

Objective:To observe the effects of Butylphthalide on serum homocysteine(Hcy),aquaporin 4(AQP4),matrix metalloproteinase-9(MMP-9)levels and nerve function in patients with cerebral edema after cerebral infarction.Method:A total of 96 patients with cerebral edema after cerebral infarction admitted to Ji’an Hospital of Shanghai Oriental Hospital were enrolled from January 2019 to December 2021.They were randomly divided into control group(n=48,routine treatments)and observation group(n=48,oral Butylphthalide Capsules on the basis of control group).The curative effect,changes in scores of national institutes of health stroke score(NIHSS)and mini-mental state examination(MMSE),changes of serum Hcy,AQP4,MMP-9 and adverse reactions were compared between the two groups.Result:The total response rate in observation group was higher than that in control group(91.67%vs 75.00%)(P<0.05).Before treatment,there were no significant differences in NIHSS score,MMSE score,Hcy,AQP4 and MMP-9 between the two groups(P>0.05).At 7,14 and 28 d for treatment,NIHSS scores were lower than those before treatment in both groups,while MMSE scores were higher than those before treatment in both groups,Hcy,AQP4 and MMP-9 in both groups after treatment were lower than those before treatment,and the changes in observation group were more significant(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion:Butylphthalide can effectively control Hcy,MMP-9,AQP4 levels and further development of cerebral edema,effectively prevent brain tissue damage,loss of neurological and cognitive function.