丁苯酞联合阿替普酶对急性缺血性脑卒中患者凝血功能及生活质量的影响
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摘要
目的探讨丁苯酞联合阿替普酶对急性缺血性脑卒中(AIS)患者凝血功能及生活质量的影响。方法选取AIS患者90例,随机分为对照组42例和观察组48例。对照组在常规治疗基础上采用阿替普酶,观察组在对照组的基础上采用丁苯酞治疗。比较2组患者的美国国立卫生院卒中量表(NIHSS)评分、临床疗效、凝血功能指标[凝血酶原时间(PT)、抗凝血酶Ⅲ(AT-Ⅲ)、纤维蛋白原(FIB)、活化部分凝血酶时间(APTT)、D-二聚体(D-D)]、功能独立性评定量表(FIM)和Spitzer生活质量指数评分表(QLI)评分。结果治疗14 d后,观察组NHISS评分显著低于对照组(P <0. 05)。观察组总有效率93. 75%,显著低于对照组78. 57%(P <0. 05)。治疗后,2组APTT、D-D及FIB水平显著低于治疗前(P <0. 05),且观察组APTT、D-D水平显著低于对照组(P <0. 05)。在FIM评分方面,对照组认知功能评分、运动功能评分和总评分显著低于观察组(P <0. 05)。对照组QLI各项评分显著低于观察组(P <0. 05)。结论丁苯酞联合阿替普酶可有效降低NHISS评分,改善凝血功能,提高FIM和QLI评分。
Objective The explore effect of butylphthalide combined with adefoenzyme on coagulation function and quality of life in patients with acute ischemic stroke( AIS). Methods Totally 90 patients with AIS were randomly divided into control group( n = 42) and observation group(n = 48). The control group was treated with adefoenzyme on the basis of conventional treatment,while the observation group was treated with butylphthalide based on the control group. The NHISS score,efficiency,blood coagulation function indexes [including prothrombin time( PT),antithrombin Ⅲ( AT-Ⅲ),fibrinogen( FIB),activated partial thrombin time( APTT),D-dimer( D-D)],FIM and QLI scores were compared between the two groups. Results After treatment for 14 days,the NHISS score of the observation group was significantly lower than that of the control group( P <0. 05). The total effective rate of the observation group was 93. 75%,which was significantly lower than 78. 57% of the control group( P < 0. 05). After treatment,the levels of APTT,D-D and FIB in both groups were significantly lower than those before treatment( P < 0. 05),and the levels of APTT and D-D in the observation group were significantly lower than those in the control group( P < 0. 05).The scores of cognitive function,motor function and total score in the control group were significantly lower than those in the observation group( P < 0. 05). The score of QLI in the control group was significantly lower than that in the observation group( P < 0. 05). Conclusion Butylphthalide combined with adefovir can effectively reduce the NHISS score,improve coagulation function,and improve the FIM and QLI scores.
Objective The explore effect of butylphthalide combined with adefoenzyme on coagulation function and quality of life in patients with acute ischemic stroke( AIS). Methods Totally 90 patients with AIS were randomly divided into control group( n = 42) and observation group(n = 48). The control group was treated with adefoenzyme on the basis of conventional treatment,while the observation group was treated with butylphthalide based on the control group. The NHISS score,efficiency,blood coagulation function indexes [including prothrombin time( PT),antithrombin Ⅲ( AT-Ⅲ),fibrinogen( FIB),activated partial thrombin time( APTT),D-dimer( D-D)],FIM and QLI scores were compared between the two groups. Results After treatment for 14 days,the NHISS score of the observation group was significantly lower than that of the control group( P <0. 05). The total effective rate of the observation group was 93. 75%,which was significantly lower than 78. 57% of the control group( P < 0. 05). After treatment,the levels of APTT,D-D and FIB in both groups were significantly lower than those before treatment( P < 0. 05),and the levels of APTT and D-D in the observation group were significantly lower than those in the control group( P < 0. 05).The scores of cognitive function,motor function and total score in the control group were significantly lower than those in the observation group( P < 0. 05). The score of QLI in the control group was significantly lower than that in the observation group( P < 0. 05). Conclusion Butylphthalide combined with adefovir can effectively reduce the NHISS score,improve coagulation function,and improve the FIM and QLI scores.
引文
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[10]赵蕊,张桂莲.丁苯酞软胶囊联合依达拉奉对急性脑梗死患者神经功能及血液流变学的影响[J].实用临床医药杂志,2015,19(11):115-116.
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[12]赵晶,赵辉,孔文基,等.阿替普酶联合丁苯酞治疗急性缺血性脑卒中的临床观察[J].中国药房,2016,27(35):4962-4965.
[13]张亮. D-二聚体、凝血指标检测在脑卒中的诊断价值[J].国际检验医学杂志,2016,37(17):2387-2388,2391.
[14]戴文卓,孔岳南.前列地尔联合丁苯肽对缺血性脑卒中患者血清炎症因子及凝血功能的影响[J].海南医学院学报,2016,22(12):1276-1278.
[15]王淑芳.急性缺血性脑卒中伴脑微出血的危险因素分析[J].医学临床研究,2017,34(1):97-99.
[16]宋志兴.凝血功能联合血液流变学检查对脑卒中的诊断价值[J].包头医学院学报,2016,32(12):29-30.
[17]潘君枝,程超禅,陈瑞炳.丁苯酞治疗对急性脑梗死患者血管内皮功能与血栓形成的影响[J].中国老年学,2015(13):3580-3582.
[18]杜磊,张小宁,雷晶,等.丁苯酞注射液对急性脑梗死患者凝血功能和神经功能的影响[J].实用心脑肺血管病杂志,2018(3):121-122.
[19]冉进.不同抗凝血药物防治脑卒中的有效性及安全性分析[J].中国实用神经疾病杂志,2015,18(08):56-57.
[20]葛海萍,姜海萍,夏海鸥.功能独立性评定在脑卒中病人日常生活活动能力评估中的应用[J].全科护理,2011,9(10):857-858.
[21]黄丽明,王利芳.依达拉奉对急性脑梗死患者神经功能及生活质量的影响[J].实用临床医药杂志,2015,19(19):121-122.
[2]赵嘉,李玲,裴中,等.丁苯酞对缺血性脑损伤作用的细胞靶点研究[J].中国卒中杂志,2010,5(2):123-129.
[3]贺新荣,郭磊.阿替普酶与尿激酶治疗急性心肌梗死60例对比观察[J].陕西医学杂志,2016,45(5):602-603.
[4]梁红英,张淑玲,张志忠.凝血、纤溶系统功能与脑卒中关系的研究[J].吉林医学,2011,32(02):238-239.
[5]中华医学会神经病学分会.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
[6]陈翔.急性缺血性脑卒中应用丁苯酞治疗的临床疗效及安全性分析[J].北方药学,2017,14(8):52-53.
[7]张巍.缺血性脑卒中患者早期神经功能障碍与患者血液高凝状态的相关性分析[J].血栓与止血学,2016,22(4):409-411.
[8]丁琪,陈旭.急性缺血性脑卒中预后影响因素研究[J].中华老年心脑血管病杂志,2016,18(11):1182-1185.
[9]马荣花.丁苯酞对急性缺血性脑卒中的保护作用[J].脑与神经疾病杂志,2014(3):217-218.
[10]赵蕊,张桂莲.丁苯酞软胶囊联合依达拉奉对急性脑梗死患者神经功能及血液流变学的影响[J].实用临床医药杂志,2015,19(11):115-116.
[11]常红,许亚红,陈琳.缺血性脑卒中患者阿替普酶静脉溶栓出血并发症的研究进展[J].中华护理杂志,2015,50(4):459-462.
[12]赵晶,赵辉,孔文基,等.阿替普酶联合丁苯酞治疗急性缺血性脑卒中的临床观察[J].中国药房,2016,27(35):4962-4965.
[13]张亮. D-二聚体、凝血指标检测在脑卒中的诊断价值[J].国际检验医学杂志,2016,37(17):2387-2388,2391.
[14]戴文卓,孔岳南.前列地尔联合丁苯肽对缺血性脑卒中患者血清炎症因子及凝血功能的影响[J].海南医学院学报,2016,22(12):1276-1278.
[15]王淑芳.急性缺血性脑卒中伴脑微出血的危险因素分析[J].医学临床研究,2017,34(1):97-99.
[16]宋志兴.凝血功能联合血液流变学检查对脑卒中的诊断价值[J].包头医学院学报,2016,32(12):29-30.
[17]潘君枝,程超禅,陈瑞炳.丁苯酞治疗对急性脑梗死患者血管内皮功能与血栓形成的影响[J].中国老年学,2015(13):3580-3582.
[18]杜磊,张小宁,雷晶,等.丁苯酞注射液对急性脑梗死患者凝血功能和神经功能的影响[J].实用心脑肺血管病杂志,2018(3):121-122.
[19]冉进.不同抗凝血药物防治脑卒中的有效性及安全性分析[J].中国实用神经疾病杂志,2015,18(08):56-57.
[20]葛海萍,姜海萍,夏海鸥.功能独立性评定在脑卒中病人日常生活活动能力评估中的应用[J].全科护理,2011,9(10):857-858.
[21]黄丽明,王利芳.依达拉奉对急性脑梗死患者神经功能及生活质量的影响[J].实用临床医药杂志,2015,19(19):121-122.