丹参川芎嗪注射液联合阿加曲班对急性脑梗死患者D-二聚体及血清炎性细胞因子水平的影响
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摘要
目的探讨丹参川芎嗪注射液联合阿加曲班对急性脑梗死患者D-二聚体及血清炎性细胞因子水平的影响。方法选取120例急性脑梗死患者,按照治疗方案分为3组。A组采用丹参川芎嗪治疗,B组采用阿加曲班治疗,C组采用丹参川芎嗪+阿加曲班治疗。比较3组患者的临床疗效及治疗前后D-二聚体、超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平的变化。结果 C组患者总有效率及脑卒中专门化生存质量量表(SS-QOL)评分显著高于A组及B组(P <0. 05)。治疗后,3组的D-二聚体、hs-CRP、IL-6、TNF-α水平较治疗前显著下降(P <0. 05),且C组与A组及B组相比有显著差异(P <0. 05)。结论采用丹参川芎嗪注射液联合阿加曲班治疗急性脑梗死安全可靠,可显著改善患者的神经功能缺失症状,降低炎性细胞因子水平,改善血液高凝状态。
Objective To explore the influence of Danshen Ligustrazine Injection combined with argatroban on levels of D-dimer and serum inflammatory cytokines in patients with acute cerebral infarction. Methods Totally 120 patients with acute cerebral infarction were divided into three groups according to treatment regimen. Group A was treated with Danshen Ligustrazine Injection,group B was treated with argatroban,and group C was treated with Danshen Ligustrazine Injection plus argatroban. The clinical effect and the changes of D-dimer,high-sensitivity C-reactive protein( hs-CRP),interleukin-6( IL-6),tumor necrosis factor-α( TNF-α) were analyzed before and after treatment. Results The total effective rate and SS-QOL score of group C were significantly higher than those of group A and group B( P < 0. 05). After treatment,the levels of D-dimer,hs-CRP,IL-6 and TNF-α in the three groups were significantly lower than those before treatment( P < 0. 05),and there were significant differences between group C and group A,group B( P < 0. 05). Conclusion Application of Danshen Ligustrazine Injection combined with argatroban is safe and reliable in the treatment of patients with acute cerebral infarction,which can significantly improve the symptoms of neurological deficit,reduce the levels of inflammatory cytokines and improve the hypercoagulability state of blood.
Objective To explore the influence of Danshen Ligustrazine Injection combined with argatroban on levels of D-dimer and serum inflammatory cytokines in patients with acute cerebral infarction. Methods Totally 120 patients with acute cerebral infarction were divided into three groups according to treatment regimen. Group A was treated with Danshen Ligustrazine Injection,group B was treated with argatroban,and group C was treated with Danshen Ligustrazine Injection plus argatroban. The clinical effect and the changes of D-dimer,high-sensitivity C-reactive protein( hs-CRP),interleukin-6( IL-6),tumor necrosis factor-α( TNF-α) were analyzed before and after treatment. Results The total effective rate and SS-QOL score of group C were significantly higher than those of group A and group B( P < 0. 05). After treatment,the levels of D-dimer,hs-CRP,IL-6 and TNF-α in the three groups were significantly lower than those before treatment( P < 0. 05),and there were significant differences between group C and group A,group B( P < 0. 05). Conclusion Application of Danshen Ligustrazine Injection combined with argatroban is safe and reliable in the treatment of patients with acute cerebral infarction,which can significantly improve the symptoms of neurological deficit,reduce the levels of inflammatory cytokines and improve the hypercoagulability state of blood.
引文
[1]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J/CD].中国医学前沿杂志:电子版,2010,2(4):50-59.
[2]中华神经科学会,中华神经外科学会.脑卒中患者临床神经功能缺损程度评分标准及临床疗效评分标准[S].中华神经科杂志,1996,29(6):381-382.
[3]张芹,王云峰,张拥波,等.卒中相关炎性生化标志物的种类及作用[J].中国卒中杂志,2013,8(4):276-280.
[4]柳丰慧,张可帅.血清白介素6、基质金属蛋白酶9、基质金属蛋白酶抑制剂1、超敏C反应蛋白及神经生长因子水平与急性脑梗死患者神经功能缺损程度的关系研究[J].实用心脑肺血管病杂志,2017,25(1):35-38.
[5]刘红.血清CRP、TNF-a含量检测对急性脑梗死患者预后情况判断的临床价值[J].海南医学院学报,2014,20(11):1545-1547.
[6]丁则昱,李晓光,崔丽英,等.急性期高敏感C反应蛋白对脑梗死预后的评估[J].中华神经科杂志,2007,40(1):11-14.
[7] Vangilder R L,Davidov D M,Stinehart K R,et al. C-reactive protein and long-term ischemic stroke prognosis.[J].Journal of Clinical Neuroscience Official Journal of the Neurosurgical Society of Australasia,2014,21(4):547-553.
[8] Zhang Y B,Yin Z,Han X,et al. Association of circulating high-sensitivity C-reactive protein with late recurrence after ischemic stroke[J]. Neuroreport,2017,28(10):598-600.
[9] Zang R S,Zhang H,Xu Y,et al. Serum C-reactive protein,fibrinogen and D-dimer in patients with progressive cerebral infarction.[J]. Translational Neuroscience,2016,7(1):84-88.
[10]孙晓燕,谢炳玓.不同梗死部位急性脑梗死患者血浆D二聚体水平变化及其与神经功能缺损程度的关系[J].山东医药,2016,56(15):57-59.
[11]尹娟.急性脑梗死患者血清基质金属蛋白酶-9和D-二聚体水平与其他危险因素相关性研究[J].中华临床医师杂志:电子版,2015,9(5):24-28.
[12] Shapir L,Gross B. DYNAMIC CHANGES OF D-DIMER FOLLOWING STROKE[J]. Harefuah,2017:302-306.
[13] Kang D,Yoo S S,Kwon K,et al. Inflammatory and hemostatic biomarkers associated with early recurrent ischemic lesions in acute ischemic stroke[J]. Stroke; a journal of cerebral circulation,2009,40(5):1653-1658.
[14]高玉芳,赵联营,王敏,等. D-二聚体检测在进展性脑梗死中的临床价值[J].检验医学与临床,2016,13(7):868-869.
[15]赵抗山,方弟晋.丹参川芎嗪注射液治疗急性脑梗死疗效及对血清MMP-9水平的影响[J].现代中西医结合杂志,2015(23):2542-2544.
[16]康梅娟.应用丹参川芎嗪注射液治疗急性脑梗塞早期临床观察[J].中药药理与临床,2015(5):117-120.
[17]董艳玲,王荣桂,李瑶宣,蔺心敬,梁浩.影响急性脑梗死患者治疗效果的相关因素分析[J].临床神经病学杂志,2013,26(03):177-179.
[18]沙瑞娟,华平,陈洁,等.阿加曲班注射液联合依达拉奉治疗急性缺血性脑梗死的临床疗效[J].现代药物与临床,2014,29(8):923-926.
[19]王以翠,常焕显,孔令胜.阿加曲班对急性脑梗死患者血管内皮功能及炎症因子的影响[J].中山大学学报:医学科学版,2015,36(6):870-876.
[2]中华神经科学会,中华神经外科学会.脑卒中患者临床神经功能缺损程度评分标准及临床疗效评分标准[S].中华神经科杂志,1996,29(6):381-382.
[3]张芹,王云峰,张拥波,等.卒中相关炎性生化标志物的种类及作用[J].中国卒中杂志,2013,8(4):276-280.
[4]柳丰慧,张可帅.血清白介素6、基质金属蛋白酶9、基质金属蛋白酶抑制剂1、超敏C反应蛋白及神经生长因子水平与急性脑梗死患者神经功能缺损程度的关系研究[J].实用心脑肺血管病杂志,2017,25(1):35-38.
[5]刘红.血清CRP、TNF-a含量检测对急性脑梗死患者预后情况判断的临床价值[J].海南医学院学报,2014,20(11):1545-1547.
[6]丁则昱,李晓光,崔丽英,等.急性期高敏感C反应蛋白对脑梗死预后的评估[J].中华神经科杂志,2007,40(1):11-14.
[7] Vangilder R L,Davidov D M,Stinehart K R,et al. C-reactive protein and long-term ischemic stroke prognosis.[J].Journal of Clinical Neuroscience Official Journal of the Neurosurgical Society of Australasia,2014,21(4):547-553.
[8] Zhang Y B,Yin Z,Han X,et al. Association of circulating high-sensitivity C-reactive protein with late recurrence after ischemic stroke[J]. Neuroreport,2017,28(10):598-600.
[9] Zang R S,Zhang H,Xu Y,et al. Serum C-reactive protein,fibrinogen and D-dimer in patients with progressive cerebral infarction.[J]. Translational Neuroscience,2016,7(1):84-88.
[10]孙晓燕,谢炳玓.不同梗死部位急性脑梗死患者血浆D二聚体水平变化及其与神经功能缺损程度的关系[J].山东医药,2016,56(15):57-59.
[11]尹娟.急性脑梗死患者血清基质金属蛋白酶-9和D-二聚体水平与其他危险因素相关性研究[J].中华临床医师杂志:电子版,2015,9(5):24-28.
[12] Shapir L,Gross B. DYNAMIC CHANGES OF D-DIMER FOLLOWING STROKE[J]. Harefuah,2017:302-306.
[13] Kang D,Yoo S S,Kwon K,et al. Inflammatory and hemostatic biomarkers associated with early recurrent ischemic lesions in acute ischemic stroke[J]. Stroke; a journal of cerebral circulation,2009,40(5):1653-1658.
[14]高玉芳,赵联营,王敏,等. D-二聚体检测在进展性脑梗死中的临床价值[J].检验医学与临床,2016,13(7):868-869.
[15]赵抗山,方弟晋.丹参川芎嗪注射液治疗急性脑梗死疗效及对血清MMP-9水平的影响[J].现代中西医结合杂志,2015(23):2542-2544.
[16]康梅娟.应用丹参川芎嗪注射液治疗急性脑梗塞早期临床观察[J].中药药理与临床,2015(5):117-120.
[17]董艳玲,王荣桂,李瑶宣,蔺心敬,梁浩.影响急性脑梗死患者治疗效果的相关因素分析[J].临床神经病学杂志,2013,26(03):177-179.
[18]沙瑞娟,华平,陈洁,等.阿加曲班注射液联合依达拉奉治疗急性缺血性脑梗死的临床疗效[J].现代药物与临床,2014,29(8):923-926.
[19]王以翠,常焕显,孔令胜.阿加曲班对急性脑梗死患者血管内皮功能及炎症因子的影响[J].中山大学学报:医学科学版,2015,36(6):870-876.