丁苯酞软胶囊联合尤瑞克林治疗分水岭脑梗死的临床研究

Clinical Study of Butylphthalide Soft Capsule Combined with Urinary Kallindinogenase in the Treatment of Cerebral Watershed Infarction

目的探讨丁苯酞软胶囊联合尤瑞克林注射液治疗急性分水岭脑梗死(cerebral watershed infarction,CWI)的临床效果。方法回顾性分析2019年1月—2022年12月于莆田市第一医院神经内科住院治疗的急性CWI患者96例的临床资料,在常规急性脑梗死治疗基础上,按照是否应用丁苯酞软胶囊分组,对照组(n=48)应用尤瑞克林注射液进行治疗,丁苯酞组(n=48)应用丁苯酞软胶囊联合尤瑞克林注射液进行治疗,观察评估两组的神经功能[美国国立卫生院神经功能缺损评分(National Institutes of Health Neurological Impairment Score,NIHSS)]、日常生活能力[日常生活能力量表(Barthel Index,BI)]、90 d临床预后[改良Rankin量表(Modified Rankin Scale,mRS)]、90 d认知功能[蒙特利尔认知评估功能量表(Montreal Cognitive Assessment,MoCA)]及不良反应总发生率差异。结果治疗前,两组NIHSS、BI、MoCA评分比较,差异无统计学意义(P>0.05)。治疗后,两组NIHSS、BI、MoCA评分均显著改善,且丁苯酞组各评分优于对照组,差异有统计学意义(P<0.05)。丁苯酞组mRS评分显著低于对照组,差异有统计学意义(P<0.05)。丁苯酞组良好预后率(83.30%)高于对照组(64.60%),差异有统计学意义(χ^(2)=4.381,P<0.05)。两组治疗期间不良反应总发生率比较,差异无统计学意义(P>0.05)。结论应用丁苯酞软胶囊联合尤瑞克林注射液治疗急性CWI,可以更好改善患者的神经功能、日常生活能力、90 d临床预后和认知功能,且安全性良好。

Objective To explore the clinical effect of butylphthalide soft capsule combined with urinary kallindinogenase injection in the treatment of acute cerebral watershed infarction(CWI).Methods The clinical date of 96 patients with acute CWI who were hospitalized in the Department of Neurology of Putian First Hospital from January 2019 to December 2022 were retrospectively analyzed.On the basis of conventional acute cerebral infarction treatment,they were grouped according to whether or not butylphthalide soft capsule was applied,the control group(n=48)was treated by application of urinary kallindinogenase injection,and the butylphthalide group(n=48)was treated by application of butylphthalide soft capsule combined with urinary kallindinogenase injection.Observations were made to assess the differences in neurological function[National Institutes of Health Neurological Impairment Score(NIHSS)],ability of daily living[Barthel Index(BI)],90 d clinical prognosis[Modified Rankin Scale(mRS)],90 d cognitive function[Montreal Cognitive Assessment(MoCA)],and the total incidence of adverse reactions between the two groups.Results There was no statistically significant difference in NIHSS score,BI score and MoCA score between the two groups before treatment(P>0.05).After treatment,NIHSS scores,BI scores and MoCA score significantly improved in both groups,and those in the butylphthalide group were better than those in the control group,and the difference was statistically significant(P<0.05).The mRS score in the butylphthalide group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).The rate of good prognosis in the butylphthalide group(83.30%)was higher than that in the control group(64.60%),and the difference was statistically significant(χ^(2)=4.381,P<0.05).There was no statistically significant difference in the total incidence of adverse reactions during treatment between the two groups(P>0.05).Conclusion The application of butylphthalide soft capsule combined with urinary kallindinogenase injection in the treatment of acute CWI can better improve the neurological function,daily living ability,90 d clinical prognosis and cognitive function of the patients,and the safety is good.