丁苯酞软胶囊联合瑞舒伐他汀治疗急性脑梗死患者的临床观察及对血清HIF-1α、Lp-PLA、Sestrin2水平的影响

Clinical observation of butylphthalein softgel combined with rosuvastatin in the treatment of acute cerebral infarction and its effect on serum HIF-1α,Lp-PLA and Sestrin2 levels

目的探究丁苯酞软胶囊联合瑞舒伐他汀治疗急性脑梗死患者的疗效及对血清缺氧诱导因子-1α(HIF-1α)、脂蛋白相关磷脂酶A2(Lp-PLA)、应激诱导蛋白2(Sestrin2)水平的影响。方法前瞻性选取2021年1月至2022年12月在秦皇岛市第一医院治疗的急性脑梗死患者101例作为研究对象,按照信封法将患者分为对照组(n=50)和研究组(n=51)。对照组行常规治疗并瑞舒伐他汀治疗,研究组在对照组基础上联合丁苯酞软胶囊治疗。统计分析两组患者治疗前及治疗14 d后的美国国立卫生研究院脑卒中量表(NIHSS)评分、FuglMeyer评测法(FMA)评分、改良Rankin量表(mRS)评分、血流动力学指标(血浆黏度、全血高切黏度、低切黏度、红细胞压积、红细胞变形指数)、血清HIF-1α、Lp-PLA、Sestrin2水平并比较临床疗效的组间差异。结果治疗14 d后,两组患者的NIHSS评分和mRS评分均较治疗前降低,FMA较治疗前升高,且研究组患者的NIHSS评分和mRS评分分别为(4.03±0.38)、(3.01±0.45)分,均低于对照组,FMA为(80.64±9.16)分,高于对照组,差异均有统计学意义(P<0.05)。治疗14 d后,两组患者的血浆黏度、全血高切黏度、低切黏度、红细胞压积均较治疗前降低,红细胞变形指数均较治疗前升高,且研究组的血浆黏度、全血高切黏度、低切黏度、红细胞压积分别为(1.56±0.33)mPa·s、(4.78±0.31)mPa·s、(9.81±0.64)mPa·s、(0.37±0.05)%,均低于对照组,红细胞变形指数为0.78±0.11,高于对照组,差异均有统计学意义(P<0.05)。治疗14 d后,两组患者的血清HIF-1α、Lp-PLA、Sestrin2水平均降低,且研究组患者血清HIF-1α、Lp-PLA、Sestrin2水平分别为(690.56±65.12)ng/mL、(13.65±2.13)μg/L、(11.33±1.45)ng/mL,均显著低于对照组,差异均有统计学意义(P<0.05)。两组近期疗效比较,差异有统计学意义(P<0.05);研究组总有效率为90.20%,高于对照组(64.00%),差异有统计学意义(P<0.05)。结论采用丁苯酞软胶囊联合瑞舒伐他汀治疗急性脑梗死患者可显著提高患者临床治疗效果,提高肢体活动能力,缓解神经功能损伤,降低血清HIF-1α、Lp-PLA、Sestrin2水平,具有较高的临床应用潜力。

Objective To explore the clinical observation of the patients with acute cerebral infarction and the effect of the serum low oxygen induced by the serum hypoxia-inducible factor-1α(HIF-1α),lipoprotein related phosphatidoenzyme A2(Lp-PLA),stress induction protein 2(Sestrin2)level.Methods A total of 101 patients with acute cerebral infarction treated in The First Hospital of Qinhuangdao from January 2021 to December 2022 were prospectively selected and grouped according to envelope method:the control group(n=50)and the study group(n=51).The control group received conventional treatment and rosuvastatin treatment,and the study group received butylphthalide soft capsules on the basis of the control group.The differences of National Institutes of Health Stroke Scale(NIHSS)score,FuglMeyer assessment(FMA)score,modified Rankin(mRS)score,hemodynamic indexes(plasma viscosity,whole blood high shear viscosity,low shear viscosity,hematocrit,and erythrocyte deformability index),serum HIF-1α,Lp-PLA,Sestrin2 levels before treatment and after 14 days of treatment,clinical efficacy between the two groups were statistically analyzed.Results After 14 days of treatment,the NIHSS score and mRS score of two groups were lower those before treatment,while the FMA score were higher those before treatment,the NIHSS score and mRS score of the study group were(4.03±0.38)and(3.01±0.45)points,respectively,which were lower than those of the control group,and the FMA score was(80.64±9.16)points,which was higher than that of the control group,the differences were statistically significant(P<0.05).After 14 days of treatment,the plasma viscosity,whole blood high shear viscosity,low shear viscosity,and hematocrit of two groups were lower than those before treatment,and the erythrocyte deformability index were higher than those before treatment,and the plasma viscosity,whole blood high shear viscosity,low shear viscosity,and hematocrit of the study group were(1.56±0.33)mPa·s,(4.78±0.31)mPa·s,(9.81±0.64)mPa·s,and(0.37±0.05)%,respectively,which were lower than those of the control group,the erythrocyte deformability index was 0.78±0.11,which was higher than that of the control group,and the differences were statistically significant(P<0.05).After 14 days of treatment,the serum levels of HIF-1α,Lp-PLA,and Sestrin2 in the two groups were lower than those before treatment,and the serum levels of HIF-1α,Lp-PLA,and Sestrin2 in the study group were(690.56±65.12)ng/mL and(13.65±2.13)μg/L and(11.33±1.45)ng/mL,respectively,which were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).There was statistically significant difference between the two groups in the short-term efficacy,and the total effective rate of the research group was 90.20%,which was higher than that of the control group(64.00%),and the difference was statistically significant(P<0.05).Conclusion In the treatment of patients with acute cerebral infarction,the combination of butylphthalein softgel capsule and rosuvastatin can effectively improve the therapeutic effect,improve the neurological injury of patients,improve the limb mobility of patients,and reduce the levels of serum HIF-1α,Lp-PLA and Sestrin2,which has a high application potential.