丁苯酞联合阿司匹林、氯吡格雷治疗进展性脑梗死的临床观察

Clinical Observation of Butylphthalide Combined with Aspirin and Clopidogrel in the Treatment of Progressive Cerebral Infarction

目的:探讨丁苯酞联合阿司匹林、氯吡格雷治疗进展性脑梗死(PCI)患者的临床疗效。方法:选取2021年9月~2023年9月期间某院收治的106例PCI患者作为研究对象,采用随机数字表法分为对照组和观察组,每组53例。对照组患者给予阿司匹林肠溶片、硫酸氢氯吡格雷片治疗,观察组患者在对照组治疗基础上加用丁苯酞氯化钠注射液,两组均连续治疗14天。比较两组患者神经功能[美国国立卫生研究院卒中量表(NIHSS)]、神经因子[神经元特异性烯醇化酶(NSE)、基质金属蛋白酶-9(MMP-9)、脑源性神经营养因子(BDNF)]、大脑血流动力学指标[平均血流速度(Vmean)、阻力指数(RI)、搏动指数(PI)]及不良反应发生情况。结果:治疗后,两组患者NIHSS评分、NSE和MMP-9均降低(P<0.05),且观察组低于对照组(P<0.05);BDNF水平均升高(P<0.05),且观察组高于对照组(P<0.05);Vmean和PI均升高(P<0.05),且观察组高于对照组(P<0.05);RI均降低(P<0.05),且观察组低于对照组(P<0.05)。两组患者不良反应总发生率比较无统计学差异(P>0.05)。结论:丁苯酞联合阿司匹林、氯吡格雷治疗可有效改善PCI患者神经功能和大脑血流动力学指标,且不会增加不良反应的发生风险。

Objective:To investigate the clinical efficacy of butylphthalide combined with aspirin and clopidogrel in the treatment of progressive cerebral infarction(PCI).Methods:A total of 106 PCI patients treated in a hospital from September 2021 to September 2023 were selected and assigned to the control group and observation group by random number table method,with 53 patients in each group.The control group was treated with aspirin enteric-coated tablets and clopidogrel bisulfate tablets,whereas the observation group was treated with butylphthalide and sodium chloride injection in addition to the treatment given in the control group,and both groups were continuously treated for 14 days.The neurological function[National Institute of Health Stroke Scale(NIHSS)],neural factors[neuron specific enolase(NSE),matrix metalloproteinase-9(MMP-9),brain-derived neurotrophic factor(BDNF)],cerebral hemodynamic parameters[mean velocity(Vmean),resistance index(RI),pulsatility index(PI)]and adverse reactions were compared between the two groups.Results:After treatment,the NIHSS score,NSE and MMP-9 were decreased in both groups(P<0.05),and were lower in the observation group than those in the control group(P<0.05).The level of BDNF was increased in both groups(P<0.05),and was higher in the observation group than that in the control group(P<0.05).The Vmean and PI were increased in both groups(P<0.05),and were higher in the observation group than those in the control group(P<0.05).The RI was decreased in both groups(P<0.05),and was lower in the observation group than that in the control group(P<0.05).No statistically significant difference in the total incidence of adverse reactions was observed between the two groups(P>0.05).Conclusion:Butylphthalide combined with aspirin and clopidogrel can effectively improve neurological function and cerebral hemodynamic parameters in patients with PCI,and does not increase the risk of adverse reactions.