丁苯酞联合阿司匹林对首发腔隙性脑梗死患者认知功能及血清内皮素-1血栓素2的影响

Effects of butylphthalide combined with aspirin on cognitive function and serum levels of ET-1 and TXB2 in patients with first-episode lacunar infarcts

目的探究丁苯酞联合阿司匹林对首发腔隙性脑梗死(LI)患者认知功能、神经功能缺损程度、脑血流动力学参数及血清内皮素-1(ET-1)和血栓素B2(TXB2)浓度的影响。方法回顾性选取2021年2月至2024年2月丽水市人民医院收治的97例首发LI患者,根据不同治疗方案分为对照组(47例)和丁苯酞组(50例),对照组接受阿司匹林治疗,丁苯酞组在对照组的基础上接受丁苯酞治疗,治疗前后对比2组患者神经功能缺损程度[美国国立卫生研究院卒中量表(NIHSS)]、认知功能[简易智力状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)]、血清中ET-1和TXB2水平和脑血流参数,并计算治疗总有效率和不良反应发生率。结果与对照组治疗后对比,丁苯酞组总有效率更高(P<0.05);治疗14 d后,丁苯酞组NIHSS评分低于对照组(P<0.05),MMSE和MoCA评分高于对照组(P<0.05);血清中ET-1和TXB2水平、峰流速和峰流速差高于对照组(P<0.05),平均流速低于对照组(P<0.05),2组不良反应发生率差异无统计学意义(P>0.05)。结论丁苯酞联合阿司匹林能够提升治疗首发LI的总有效率,修复神经功能损伤,改善认知功能,调节血清中ET-1和TXB2水平和脑血流灌注,且安全性良好。

Objective To explore the effects of butyphthalide combined with aspirin on cognitive function,severity of neurological impairment,cerebral hemodynamics parameters,serum endothelin-1(ET-1)and thrombox-ane B2(TXB2)in patients with first-episode lacunar infarcts(LI).Methods A total of 97 patients with first-episode LI in Lishui People′s Hospital were retrospectively enrolled between February 2021 and February 2024.According to different treatment methods,they were divided into a control group(47 cases,aspirin)and a butyph-thalide group(50 cases,butyphthalide combined with aspirin).Before and after treatment,severity of neurological impairment[National Institutes of Health Stroke Scale(NIHSS)],cognitive function[mini-mental state examination(MMSE),Montreal Cognitive Assessment Scale(MoCA)],serum ET-1,TXB2 and cerebral hemodynamics parame-ters in the two groups were compared.The total response rate of treatment(reduction rate of NIHSS)and incidence of adverse reactions were calculated.Results After treatment,total response rate in butyphthalide group was higher than that in control group(P<0.05).After 14d of treatment,NIHSS score in butyphthalide group was lower than that in control group(P<0.05),MMSE and MoCA scores were higher than those in control group(P<0.05).The levels of serum ET-1 and TXB2,peak velocity and difference value of peak velocity in butyphthalide group were higher than those in control group(P<0.05),while mean velocity was slower than that in control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Butyphthalide combined with aspirin can improve total response rate of treatment,repair nerve func-tion injury,improve cognitive function,regulate serum ET-1,TXB2 and cerebral blood flow perfusion in patients with first-episode LI,and has good safety.