摘要
目的:观察消栓肠溶胶囊联合大剂量降纤酶对急性脑梗死伴发颈动脉粥样硬化斑块患者脑血流指标及血小板表面α-颗粒膜糖蛋白(CD62P)、血小板溶酶体膜糖蛋白(CD63)分子表达的影响。方法:选取84例急性脑梗死伴发颈动脉粥样硬化斑块患者,按照随机数字表法分为观察组和对照组各42例。所有患者均给予基础治疗,在此基础上对照组给予大剂量降纤酶治疗,观察组在对照组基础上联合消栓肠溶胶囊治疗。对比2组中医证候积分及临床疗效,检测患者治疗前后的脑循环动力学参数、血脂指标及CD62P、CD63分子表达水平。结果:治疗后,2组中医证候积分均较治疗前降低(P <0.05),观察组中医证候积分比对照组降低更明显(P <0.05)。总有效率观察组95.24%,高于对照组的76.19%(P <0.05)。治疗后,2组平均血流速、平均血流量均较治疗前增加(P <0.05),外周阻力、脑血管床特性阻抗水平均较治疗前降低(P <0.05);观察组平均血流速、平均血流量均高于对照组(P <0.05),外周阻力、脑血管床特性阻抗水平均低于对照组(P <0.05)。治疗后,2组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)水平均较治疗前降低(P <0.05),高密度脂蛋白(HDL)水平均较治疗前升高(P <0.05);观察组TC、TG、LDL水平均低于对照组(P <0.05),HDL水平高于对照组(P <0.05)。治疗后,2组CD62P、CD63分子表达水平均较治疗前降低(P <0.05),观察组CD62P、CD63分子表达水平均低于对照组(P <0.05)。结论:消栓肠溶胶囊联合大剂量降纤酶应用于急性脑梗死伴发颈动脉粥样硬化斑块患者有显著的治疗效果,脑循环动力学参数及血脂指标均有较大改善,CD62P、CD63分子表达水平有所降低,值得临床推广。
Objective:To observe the effect of Xiaoshuang Changrong capsules combined with high-dose defibrase on the indexes of cerebral blood flow and the expression of platelet surfaceα-granule membrane glycoprotein(CD62 P)and platelet lysosomal membrane protein(CD63)in patients with acute cerebral infarction complicated with carotid atherosclerotic plaques.Methods:A total of 84 cases of patients with acute cerebral infarction complicated with carotid atherosclerotic plaques were divided into the observation group and the control group according to the random number table method,42 cases in each group.Both groups were given routine treatment.The control group was additionally treated with high-dose defibrase,and the observation group was additionally treated with Xiaoshuang Changrong capsules based on the treatment of the control group.The Chinese medicine syndrome scores and the clinical effect in the two groups were compared;the cerebral hemodynamic parameters,the indexes of serum lipids and the levels of expression of CD62 P and CD63 before and after treatment were detected.Results:After treatment,the Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment(P<0.05),and the decrease in the observation group was more obvious than that in the control group(P<0.05).The total effecti ve rate was 95.24%in the observation group,higher than that of 76.19%in the control group(P<0.05).After treatment,the mean flow velocity and the mean blood flow in the two groups were increased when compared with those before treatment(P<0.05),while the levels of peripheral resistance and cerebral vascular characteristic impedance in the two groups were decreased when compared with those before treatment(P<0.05);the mean flow velocity and the mean blood flow in the observation group were higher than those in the control group(P<0.05),while the levels of peripheral resistance and cerebral vascular characteristic impedance in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of total cholesterol(TC),triglyceride(TG)and low density lipoprotein(LDL)in the two groups were decreased when compared with those before treatment(P<0.05),while the levels of high density lipoprotein(HDL)in the two groups were increased when compared with those before treatment(P<0.05);the levels of TC,TG and LDL in the observation group were lower than those in the control group(P<0.05),while the level of HDL in the observation group was higher than that in the control group(P<0.05).After treatment,the levels of expression of CD62 P and CD63 in the two groups were decreased when compared with those before treatment(P<0.05),and the above levels in the observation group were lower than those in the control group(P<0.05).Conclusion:The therapy of Xiaoshuang Changrong capsules combined with high-dose defibrase has significant curative effect in treating acute cerebral infarction complicated with carotid atherosclerotic plaques.The cerebral hemodynamic parameters and the indexes of serum lipids were significantly improved,and the levels of expression of CD62 P and CD63 were decreased.Therefore,the therapy is worthy of clinical promotion.
作者
王文敏
周海平
周荣
张叶青
石涵
WANG Wenmin;ZHOU Haiping;ZHOU Rong;ZHANG Yeqing;SHI Han
出处
《新中医》
CAS
2019年第8期109-112,共4页
New Chinese Medicine