观察硫酸氢氯吡格雷片联合丁苯酞软胶囊治疗脑梗死的疗效及对其血清特异性指标的影响

Observation on the therapeutic effect of clopidogrel hydrogen sulphate tablets combined with butylphthalein soft capsules on cerebral infarction and its influence on serum specific indicators

目的探究硫酸氢氯吡格雷片联合丁苯酞软胶囊治疗脑梗死的疗效及对其血清特异性指标的影响,以丰富临床的理论依据。方法80例脑梗死患者,以随机平行对照法分成对照组(40例)和观察组(40例)。对照组采取硫酸氢氯吡格雷片治疗,观察组采取硫酸氢氯吡格雷片联合丁苯酞软胶囊治疗。比较两组血清特异性指标(血清S100-β蛋白、CD40L)、脑循环血量参数(脑血管平均血流速度、血管外周阻力、血管特性阻抗)、神经营养[脑源性神经营养因子(BDNF)、神经生长因子(NGF)]水平、生活质量[脑卒中专用生活质量量表(SS-QOL)评分]及临床效果。结果观察组治疗总有效率90.00%比对照组的72.50%更高(P<0.05)。两组治疗后血清S100-β蛋白、CD40L水平比本组治疗前更低,且观察组血清S100-β蛋白(0.23±0.05)ng/ml、CD40L(9.69±1.34)μg/L比对照组的(0.41±0.12)ng/ml、(11.57±2.01)μg/L更低(P<0.05)。两组治疗后脑血管平均血流速度比本组治疗前更高,血管外周阻力、血管特性阻抗比本组治疗前更低,且观察组脑血管平均血流速度(11.60±5.22)cm/s高于对照组的(8.89±4.73)cm/s,血管外周阻力(2367.31±129.16)BSA、血管特性阻抗(3017.83±136.95)dyn·s/cm^(5)低于对照组的(2861.42±137.20)BSA、(4089.35±160.74)dyn·s/cm^(5)(P<0.05)。两组治疗后血清BDNF、NGF水平比本组治疗前更高,且观察组血清BDNF(4.35±0.83)ng/ml、NGF(138.36±18.92)pg/ml比对照组的(3.17±0.72)ng/ml、(126.53±19.09)pg/ml更高(P<0.05)。两组治疗后SS-QOL体能、活动能力、自理、社会角色、上肢功能、工作能力评分比本组治疗前更高,且观察组SS-QOL体能、活动能力、自理、社会角色、上肢功能、工作能力评分比对照组更高(P<0.05)。结论硫酸氢氯吡格雷片联合丁苯酞软胶囊可作为脑梗死疾病的有效治疗方案,其能够改善患者血清特异性指标的异常水平,提高神经营养水平,促进脑部血液循环,有助于早日康复。

Objective To explore the therapeutic effect of clopidogrel hydrogen sulphate tablets combined with butylphthalein soft capsules on cerebral infarction and its influence on serum specific indicators,so as to enrich clinical theoretical basis.Methods 80 patients with cerebral infarction were randomly divided into a control group(40 cases)and an observation group(40 cases).The control group was treated with clopidogrel hydrogen sulphate tablets,and the observation group was treated with clopidogrel hydrogen sulphate tablets combined with butylphthalein soft capsules.Both groups were compared in terms of serum specific indicators(serum S100-βprotein,CD40L),cerebral circulation blood volume parameters(average cerebral blood flow velocity,peripheral vascular resistance,vascular characteristic impedance),neurotrophin[brain-derived neurotrophic factor(BDNF),nerve growth factor(NGF)]levels,quality of life[stroke specific quality of life scale(SS-QOL)score]and clinical effect.Results The total effective rate of the observation group was 90.00%,which was higher than 72.50%of the control group(P<0.05).After treatment,the serum levels of S100-βprotein and CD40L in both groups were lower than those before treatment in this group;the observation group had serum S100-βprotein of(0.23±0.05)ng/ml and CD40L of(9.69±1.34)μg/L,which were lower than(0.41±0.12)ng/ml and(11.57±2.01)μg/L in the control group(P<0.05).After treatment,the average cerebral blood flow velocity in both groups was higher than that before treatment in this group,and the peripheral vascular resistance,vascular characteristic impedance were lower than those before treatmentin this group;the observation group had higher average cerebral blood flow velocity of(11.60±5.22)cm/s than(8.89±4.73)cm/s in the control group;the observation group had the peripheral vascular resistance of(2367.31±129.16)BSA and vascular characteristic impedance of(3017.83±136.95)dyn·s/cm^(5),which were lower than(2861.42±137.20)BSA and(4089.35±160.74)dyn·s/cm^(5) in the control group(P<0.05).After treatment,the levels of serum BDNF and NGF in both groups were higher than those before treatment in this group;the observation group had serum BDNF of(4.35±0.83)ng/ml and NGF of(138.36±18.92)pg/ml,which were higher than(3.17±0.72)ng/ml and(126.53±19.09)pg/ml in the control group(P<0.05).After treatment,the SS-QOL scores of physical fitness,mobility,self-care,social role,upper limb function and working ability of the two groups were higher than those before treatment;the SS-QOL scores of physical fitness,activity ability,self-care,social role,upper limb function and work ability in the observation group were higher than those in the control group(P<0.05).Conclusion Clopidogrel hydrogen sulphate tablets combined with butylphthalein soft capsules can be used as an effective treatment for cerebral infarction,which can improve the serum specific indicators,improve the level of neuronutrition,promote brain blood circulation,and contribute to early recovery of patients.