丁苯酞对急性脑梗死患者认知功能及血清神经元特异烯醇化酶和S100B蛋白水平的影响

The Effects of DL-3-n-butylphthalide on the Cognitive Function and Serum Levels of Neuron-specific Enolase and S100B in Patients with Acute Ischemic Stroke

探讨丁苯酞对急性脑梗死患者认知功能的改善作用及其对患者血清神经元特异烯醇化酶和S100B蛋白水平的影响。选取2021年6月至2023年6月于本院就诊的急性脑梗死患者119例,随机分为观察组59例和对照组60例。观察组在常规治疗基础上给予丁苯酞静脉滴注14 d续以丁苯酞软胶囊口服治疗76 d,对照组仅给予常规治疗。收集治疗前后两组患者的神经功能损伤和认知功能状况、以及血清神经元特异烯醇化酶和S100B蛋白水平。两组患者在基线水平神经功能损伤评分、认知功能评分、及血清神经元特异烯醇化酶和S100B蛋白水平无明显差异(P>0.05),治疗后两组患者上述指标均有明显改善(P<0.05)。与对照组相比,观察组患者美国国立卫生研究院卒中量表评分下降更明显,简易智力状态检查量表升高更明显(P<0.05)。此外,丁苯酞治疗组患者血清神经元特异烯醇化酶和S100B蛋白水平较对照组患者下降更明显(P<0.01)。本研究结果提示,丁苯酞对急性脑梗死患者认知功能具有明显的改善作用,同时能够有效降低患者的神经系统损伤指标。未来需要更大规模的多中心前瞻性研究和基础研究证明丁苯酞在改善急性脑梗死患者认知功能中的作用和确切机制。

To investigate the effects of DL-3-n-butylphthalide on the cognitive function and serum levels of neuron-specific enolase and S100B in patients with acute ischemic stroke,a total of 119 patients with acute ischemic stroke were enrolled from June 2021 to June 2023 and randomly divided into study group(n=59)and control group(n=60).The study group received injection of DL-3-nbutylphthalide for 14 days followed by oral administration of DL-3-n-butylphthalide capsule for 76 days combined with conditional therapy,while the control group only received conditional therapy.The changes of nervous system injury and cognitive function,as well as the serum levels of neuron-specific enolase and S100B were investigated before and after treatment.After 90 days treatment,the degree of nervous system injury and cognitive dysfunction were improved while the serum levels of neuron-specific enolase and S100B were decreased in both of the two groups(P<0.05).However,the score of National Institute of Health stroke scale was lower while the score of Mini-mental State Examination was higher in patients in the study group than those in the control group(P<0.05).Moreover,the serum levels of neuron-specific enolase and S100B were decreased more significantly in patients treated with DL-3-nbutylphthalide when compared to those without DL-3-n-butylphthalide treatment(P<0.01).Taken together,the authors’study indicates that DL-3-n-butylphthalide could improve the cognitive dysfunction and decrease the biomarkers of neurological injury in patients with acute ischemic stroke.Further prospective multicenter studies and molecular studies will be needed to confirm the effects and the underlying mechanism of DL-3-n-butylphthalide on the treatment of patients with acute ischemic stroke.