丁苯酞软胶囊联合依达拉奉对急性脑梗塞患者神经功能缺损及血浆纤维蛋白原的影响
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摘要
目的旨在探讨丁苯酞软胶囊联合依达拉奉对急性脑梗塞患者神经功能缺损及血浆纤维蛋白原的影响。方法选取我院2016年11月～2017年12月收治的急性脑梗塞患者94例,根据患者治疗方案的不同,将94例患者分为对照组及观察组,每组各47例。对照组患者在常规内科治疗的基础上采用依达拉奉进行治疗,观察组在对照组的基础上联合丁苯酞软胶囊进行治疗。比较两组患者治疗前后神经功能缺损变化情况、临床疗效、治疗前后血浆纤维蛋白原(plasma fibrinogen,FIB)、血液流变学、血脂、血清神经元特异性烯醇化酶(neuron-specific enolase,NSE)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、生活质量水平变化情况及不良反应。结果观察组患者临床疗效总有效率为95.74%,对照组患者临床疗效总有效率为76.59%,观察组临床疗效总有效率明显优于对照组,差异具有统计学意义(P<0.05);两组患者治疗前FIB、血浆黏度、全血低切、高切黏度、LDL、TC、HDL水平无明显差异(P>0.05);两组患者治疗后FIB、血浆黏度、全血低切、高切黏度、LDL、TC、HDL水平均较治疗前出现明显变化,FIB、血浆黏度、全血低切、高切黏度、LDL、TC明显下降,HDL水平明显上升(P<0.05);治疗后,观察组FIB、血浆黏度、全血低切、高切黏度、LDL、TC下降幅度显著高于对照组,HDL水平上升幅度明显高于对照组(P<0.05);治疗后观察组NIHSS评分下降幅度显著高于对照组(P<0.001);观察组患者治疗后血清NSE、IL-6、TNF-α下降幅度明显大于对照组(P<0.05);观察组治疗后RP、BP、MH、RE、VT、SF评分水平明显高于对照组(P<0.05);两组患者在治疗过程中均未出现严重不良反应。结论丁苯酞软胶囊联合依达拉奉治疗急性脑梗塞患者临床疗效显著,能有效改善患者神经功能缺损程度、血浆FIB指标水平,提高患者生活质量水平,安全性高。
Objective To investigate the effect of butylphthalide soft capsule combined with edaravone on neurological deficit and plasma fibrinogen in patients with acute cerebral infarction. Methods Between January 2016 and December 2017, 94 acute cerebral infarction patients admitted to our hospital were selected and divided into control group and observation group according to different treatment plans. Patients in the control group were treated with routine medical therapy and edaravone. Based on this, the observation group received the butylphthalide soft capsule. The changes of neurological deficits, clinical efficacy, plasma fibrinogen(FIB), hemorheology, blood lipids, serum neuron-specific enolase(NSE), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), quality of life and adverse reactions were compared between the two groups before and after treatment. Results The total effective rate in the observation group was significantly higher than that in the control group(95.74% vs 76.59%, P<0.05). The FIB, plasma viscosity, low/high notch viscosity of the whole blood, LDL, TC, HDL of the two groups had no significant difference before treatment. The above levels except HDL were all decreased after treatment(P<0.05). Both the increasing level and decreasing level were more significant in the observation group than in the control group(P<0.05). The decreasing level of the NIHSS score in the observation group was more obvious than in the control group(P<0.001). The decrease of serum NSE, IL-6 and TNF-α in the observation group was significantly greater than that in the control group(P<0.05). The scores of RP, BP, MH, RE, VT and SF in the observation group were significantly higher than those in the control group(P<0.05). No serious adverse reactions occurred in both groups of patients during the treatment. Conclusion The butylphthalide soft capsule combined with edaravone is an effective and safe way to ameliorate the neurological deficit degree, plasma FIB index and quality of life for acute cerebral infarction patients.
Objective To investigate the effect of butylphthalide soft capsule combined with edaravone on neurological deficit and plasma fibrinogen in patients with acute cerebral infarction. Methods Between January 2016 and December 2017, 94 acute cerebral infarction patients admitted to our hospital were selected and divided into control group and observation group according to different treatment plans. Patients in the control group were treated with routine medical therapy and edaravone. Based on this, the observation group received the butylphthalide soft capsule. The changes of neurological deficits, clinical efficacy, plasma fibrinogen(FIB), hemorheology, blood lipids, serum neuron-specific enolase(NSE), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), quality of life and adverse reactions were compared between the two groups before and after treatment. Results The total effective rate in the observation group was significantly higher than that in the control group(95.74% vs 76.59%, P<0.05). The FIB, plasma viscosity, low/high notch viscosity of the whole blood, LDL, TC, HDL of the two groups had no significant difference before treatment. The above levels except HDL were all decreased after treatment(P<0.05). Both the increasing level and decreasing level were more significant in the observation group than in the control group(P<0.05). The decreasing level of the NIHSS score in the observation group was more obvious than in the control group(P<0.001). The decrease of serum NSE, IL-6 and TNF-α in the observation group was significantly greater than that in the control group(P<0.05). The scores of RP, BP, MH, RE, VT and SF in the observation group were significantly higher than those in the control group(P<0.05). No serious adverse reactions occurred in both groups of patients during the treatment. Conclusion The butylphthalide soft capsule combined with edaravone is an effective and safe way to ameliorate the neurological deficit degree, plasma FIB index and quality of life for acute cerebral infarction patients.
引文
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[25] Saito T,Hayashi K,Nakazawa H,et al.Clinical Characteristics and Lesions Responsible for Swallowing Hesitation After Acute Cerebral Infarction[J].Dysphagia,2016,31(4):567-573.
[26] 梅炳银,舒志刚,张阳,等.急性进展性脑梗死患者神经功能缺损与血小板参数变化的关系[J].血栓与止血学,2016,22(4):412-414.
[27] 钟平,刘时华,程燕,等.循环内皮祖细胞与脑梗死急性期神经功能缺损症状的关系研究[J].中华全科医学,2017,15(8):1297-1300.
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[29] 张国昌.急性与陈旧性脑梗死临床诊断中D-二聚体/FDP比值的价值探讨[J].保健医学研究与实践,2016,13(1):73-74.
[30] 詹燕,刘佩军,肖承承,等.丁苯酞软胶囊对中青年缺血性卒中患者认知功能的影响[J].中国新药杂志,2017,25(13):1546-1550.
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[2] 陈光生,林伯昌,朱伟明,等.丁苯酞软胶囊治疗急性脑梗死的疗效观察[J].现代药物与临床,2017,32(8):1429-1432.
[3] Hori Y S,Kodera S,Sato Y,et al.Eosinopenia as a Predictive Factor of the Short-Term Risk of Mortality and Infection after Acute Cerebral Infarction[J].Journal of Stroke & Cerebrovascular Diseases the Official Journal of National Stroke Association,2016,25(6):1307-1312.
[4] 严秋凤,谢宁.丁苯酞胶囊对急性脑梗死患者血清SOD、NSE的影响[J].中南药学,2017,14(4):535-537.
[5] 王鹏,刘华坤,张磊,等.丁苯酞腹腔注射对大鼠局灶性脑缺血再灌注损伤的预防作用及其机制探讨[J].山东医药,2016,56(15):38-40.
[6] 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].中国全科医学,2011,14(35):4013-4017.
[7] 陈伟群,王新德.全国第五届脑血管病学术会议纪要[J].中华神经科杂志,2000,33(4):59-61.
[8] 牛慧艳,张占强,王海,等.丁苯酞软胶囊联合阿托伐他汀钙对急性脑梗死患者血清IL-6、IL-8和动脉粥样硬化斑块的影响[J].现代中西医结合杂志,2017,26(27):2968-2971.
[9] 孙桂香.氟伐他汀与丁苯酞软胶囊联合治疗对急性脑梗死患者的影响[J].国际免疫学杂志,2016,39(4):343-347.
[10] 薛朝军,靳会欣,张旭东.丁苯酞及其衍生物对脑卒中作用机制的研究进展[J].药学服务与研究,2017,17(6):401-404.
[11] 陶黎,李花.丁苯酞联合阿托伐他汀对急性脑梗死患者血清 NSE、ANG I I、Hcy、炎性因子及凝血功能指标水平的影响[J].海南医学院学报,2016,22(21):2609-2612.
[12] 黄廷富,何永利,潘小平.急性脑梗死患者神经功能缺损与血清PON-1和OX—LDL水平的相关性研究[J].卒中与神经疾病,2016,23(4):250-254.
[13] Naess H,Kurtz M,Thomassen L,et al.Serial NIHSS scores in patients with acute cerebral infarction[J].Acta Neurologica Scandinavica,2016,133(6):415.
[14] 任博,李琳,蔡鲁平,等.丁苯酞软胶囊治疗脑梗死的临床研究[J].现代药物与临床,2017,32(9):1660-1663.
[15] 章耀华,马志伟,王海茹.丁苯酞联合丹参酮注射液治疗急性脑梗死临床疗效观察[J].实用老年医学,2017,31(11):1082-1083.
[16] 曹栋.丁苯酞软胶囊联合人尿激肽原酶治疗进展性脑梗死的临床疗效观察[J].神经损伤与功能重建,2016,11(4):346-347.
[17] 何奕涛,郭毅.急性脑梗死后认知功能障碍与血同型半胱氨酸的相关性[J].广东医学,2015,53(11):1678-1681.
[18] 俞小梅,王喜丰,张静,等.丁苯酞注射液及丁苯酞胶囊治疗急性脑梗死患者的临床疗效对比[J].实用医学杂志,2016,32(17):2921-2924.
[19] 任彩霞,余凡,余永平.丁苯酞注射液治疗急性脑梗死疗效观察[J].陕西医学杂志,2016,45(7):909-910.
[20] 赵卫东.依达拉奉联合丹红注射液治疗急性脑梗死的临床效果[J].河北医药,2017,39(12):1863-1865.
[21] 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.
[22] 冯锦丽,王卫.急性脑梗死患者循环miR-124表达水平与脑梗死体积、神经功能缺损程度的关系及其诊断价值[J].卒中与神经疾病,2018,24(1):124-125.
[23] 边丽丽,谷小芳,刘芳,等.依达拉奉联合丹红对急性脑梗死患者炎症反应及氧化应激的影响[J].医学临床研究,2017,34(3):558-560.
[24] 左毅,吴婉玉.依达拉奉在急性脑梗死静脉溶栓再灌注损伤中应用效果及保护作用机制研究[J].解放军医药杂志,2017,28(4):65-69.
[25] Saito T,Hayashi K,Nakazawa H,et al.Clinical Characteristics and Lesions Responsible for Swallowing Hesitation After Acute Cerebral Infarction[J].Dysphagia,2016,31(4):567-573.
[26] 梅炳银,舒志刚,张阳,等.急性进展性脑梗死患者神经功能缺损与血小板参数变化的关系[J].血栓与止血学,2016,22(4):412-414.
[27] 钟平,刘时华,程燕,等.循环内皮祖细胞与脑梗死急性期神经功能缺损症状的关系研究[J].中华全科医学,2017,15(8):1297-1300.
[28] 刘佳,崔红莉,思迪克江·吾甫尔,等.中西医结合治疗急性脑梗死的临床疗效观察[J].实用心脑肺血管病杂志,2016,23(7):210-211.
[29] 张国昌.急性与陈旧性脑梗死临床诊断中D-二聚体/FDP比值的价值探讨[J].保健医学研究与实践,2016,13(1):73-74.
[30] 詹燕,刘佩军,肖承承,等.丁苯酞软胶囊对中青年缺血性卒中患者认知功能的影响[J].中国新药杂志,2017,25(13):1546-1550.
[31] 陈海恋,何超明,庞明武,等.丁苯酞治疗老年急性脑梗死的疗效及对细胞因子和神经功能的影响[J].中华老年心脑血管病杂志,2016,18(11):1173-1177.
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