阿加曲班联合米氮平对脑小血管病患者脑源性神经营养因子水平的影响

Effect of argatroban combined with mirtazapine on the levels of brain-derived neurotrophic factor in patients with cerebral small vascular disease

目的探讨阿加曲班联合米氮平对脑小血管病(cerebral small vascular disease,CSVD)患者情感障碍及脑源性神经营养因子(brain derived neurotrophic factor,BDNF)水平的影响。方法选取120例CSVD患者,随机分为对照组和观察组,每组60例,分别给予奥扎格雷钠联合米氮平治疗及阿加曲班联合米氮平治疗。用酶联免疫吸附试验测定超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)和血管内皮生长因子(vascular endothelial growth factor,VEGF)水平;检测全血黏度、血浆黏度、红细胞压积和血沉。对比2组的临床疗效、不良反应的发生情况及美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分和汉密尔顿抑郁量表(Hamilton depression scale,HAMD)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评分。结果治疗后所有患者的全血黏度、血浆黏度、红细胞压积和血沉均降低;且观察组低于对照组(P<0.05)。所有患者的hs-CRP、VEGF水平均降低,BDNF水平升高;相比对照组,观察组hs-CRP、VEGF的水平更低,BDNF的水平更高(P<0.05);治疗后2组患者的HAMD、HAMA、NIHSS评分均降低,且观察组低于对照组(P<0.05);观察组的总有效率(91.67%)高于对照组(76.67%)(P<0.05);观察组的不良反应总发生率(11.67%)高于对照组(10.00%),但差异无统计学意义(P>0.05)。结论阿加曲班联合米氮平治疗CSVD患者可有效提高临床疗效,并能有效提高BDNF水平,改善患者的血液流变学及焦虑、抑郁等负面情绪。

Objective To explore the effect of argatroban combined with mirtazapine on the levels of brain derived neurotrophic factor(BDNF)in patients with cerebral small vascular disease(CSVD).Methods A total of 120 patients with CSVD were selected and randomly divided into control group and observation group,60 cases in each group.The control group was given ozagrel sodium and mirtazapine treatment,while the observation group was given argatroban and mirtazapine treatment.The hypersensitive C-reactive protein(hs-CRP)and BDNF were measured by enzyme-linked immunosorbent assay.The vascular endothelial growth factor(VEGF),whole blood viscosity,plasma viscosity,hematocrit and erythrocyte sedimentation rate(ESR)were measured by automatic blood analyzer.The clinical efficacy,the incidence of adverse reactions,the National Institute of Health stroke scale(NIHSS),Hamilton depression scale(HAMD)and Hamilton anxiety scale(HAMA)were compared between the 2 groups.Results After treatment,the whole blood viscosity,plasma viscosity,hematocrit and erythrocyte sedimentation rate in 2 groups decreased.The hemorheological levels of the observation group was lower than that of the control group(P<0.05).The hs-CRP and VEGF decreased,while the levels of BDNF increased in 2 groups.Compared with the control group,the hs-CRP and VEGF levels were lower and BDNF levels were higher in the observation group(P<0.05).After treatment,the HAMD,HAMA and NIHSS scores in the 2 groups decreased,and the HAMD,HAMA and NIHSS scores in the observation group were lower than those of control group(P<0.05).The total effective rate of observation group(91.67%)was higher than that of control group(76.67%)(P<0.05).The total incidence of adverse reactions in the observation group(11.67%)was higher than that in the control group(10.00%),with no statistical difference(P>0.05).Conclusion The combined treatment of argatroban and mirtazapine can effectively improve the clinical efficacy of patients with CSVD,and can effectively improve the level of BDNF,improve patients hemorheology,anxiety,depression and other negative emotions,which is worthy of clinical application.