丁苯酞注射液对急性大脑中动脉供血区卒中患者的疗效及对脑血管CO_2反应性的影响
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摘要
目的探讨丁苯酞注射液对急性大脑中动脉供血区卒中患者的疗效及对脑血管CO2反应性(CO2R)的影响。方法选择2014年1月—2017年8月在河南大学附属南阳南石医院神经内科诊治的119例急性大脑中动脉供血区卒中患者,根据治疗方法的不同分为观察组69例与对照组50例。对照组采用常规药物治疗,观察组在对照组基础上联合丁苯酞注射液治疗,两组治疗观察28 d。比较两组临床疗效、简明智力状态检查量表(MMSE)评分、脑梗死体积及脑血管CO2R变化情况。结果观察组的总有效率为99.55%,显著高于对照组的88.00%(P<0.05)。治疗后两组的脑梗死体积都较治疗前显著下降(P<0.05),且观察组显著低于对照组(P<0.05)。两组治疗后的MMSE评分都显著高于治疗前(P<0.05),且观察组显著高于对照组(P<0.05)。治疗后两组的屏气指数都显著高于治疗前(P<0.05),且观察组显著高于对照组(P<0.05)。结论丁苯酞注射液在急性大脑中动脉供血区卒中患者中的应用能改善脑血管CO2R状况,提高治疗效果与缩小脑梗死体积,促进认知功能的恢复。
Objective To explore the effect of butylphthalide Injection on cerebral vascular CO2 reaction(CO2 R) in patients with acute middle cerebral artery blood supply area stroke.Methods From January 2014 to August 2017, 119 patients with acute middle cerebral artery blood supply area stroke were selected and were divided into the 69 patients in the observation group and the 50 patients of the control group accorded to the different treatment methods, the control group were treated with conventional drugs, the observation group were treated with Butylphthalide Injection on the basis of the control group, and the two groups were treated with28 d. The changes of CO2 R in cerebral vessels were recorded. Results All the patients were completed the treatment. The total effective rates of the observation group and the control group were 92.8% and 60%, respectively, and the observation group were significantly higher than the control group(P < 0.05). After treatment, the volume of cerebral infarction in the two groups were decreased significantly(P < 0.05), and the decreased values in the observation group were significantly more than that in the control group(P < 0.05). After treatment, the MMSE scores of the two groups were significantly higher than those before treatment, and the score of the observation group were also higher than that of the control group after treatment(P < 0.05). After treatment, the breath holding index of the observation group and the control group were significantly higher than those before treatment(P < 0.05), and the observation group were also higher than that of the control group(P < 0.05). Conclusion The application of Butylphthalide Injection in stroke patients with acute middle cerebral artery blood supply area stroke can improve the status of cerebral vascular CO2 R, improve the therapeutic effect and reduce the volume of cerebral infarction, and promote the recovery of cognitive function.
Objective To explore the effect of butylphthalide Injection on cerebral vascular CO2 reaction(CO2 R) in patients with acute middle cerebral artery blood supply area stroke.Methods From January 2014 to August 2017, 119 patients with acute middle cerebral artery blood supply area stroke were selected and were divided into the 69 patients in the observation group and the 50 patients of the control group accorded to the different treatment methods, the control group were treated with conventional drugs, the observation group were treated with Butylphthalide Injection on the basis of the control group, and the two groups were treated with28 d. The changes of CO2 R in cerebral vessels were recorded. Results All the patients were completed the treatment. The total effective rates of the observation group and the control group were 92.8% and 60%, respectively, and the observation group were significantly higher than the control group(P < 0.05). After treatment, the volume of cerebral infarction in the two groups were decreased significantly(P < 0.05), and the decreased values in the observation group were significantly more than that in the control group(P < 0.05). After treatment, the MMSE scores of the two groups were significantly higher than those before treatment, and the score of the observation group were also higher than that of the control group after treatment(P < 0.05). After treatment, the breath holding index of the observation group and the control group were significantly higher than those before treatment(P < 0.05), and the observation group were also higher than that of the control group(P < 0.05). Conclusion The application of Butylphthalide Injection in stroke patients with acute middle cerebral artery blood supply area stroke can improve the status of cerebral vascular CO2 R, improve the therapeutic effect and reduce the volume of cerebral infarction, and promote the recovery of cognitive function.
引文
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[11] Sun Y, Cheng X, Wang H, et al. dl-3-n-butylphthalide promotes neuroplasticity and motor recovery in stroke rats[J]. Behav Brain Res, 2017, 30(329):67-74.
[12]韩献军,黄红莉,单树崇.磁敏感加权成像毛刷征与急性缺血性卒中患者血管反应性的关系[J].国际脑血管病杂志, 2014, 22(2):99-104.
[13] Li J, Wang X L, Wang A P, et al. Toxicokinetics and toxicity of potassium 2-(1-hydroxypentyl)-benzoate in beagle dogs[J]. J Asian Nat Prod Res, 2017, 19(4):388-401.
[14] Zhao Y, Lee J H, Chen D, et al. DL-3-n-butylphthalide induced neuroprotection, regenerative repair, functional recovery and psychological benefits following traumatic brain injury in mice[J]. Neurochem Int, 2017, 12(111):82-92.
[15]高宇海,石进,张英谦,等.症状性大脑中动脉狭窄患者支架置入术对脑血管反应性的影响[J].中华老年心脑血管病杂志, 2017, 19(2):126-129.
[16] Xiang W, Xue H, Wang B, et al. Efficacy of Nbutylphthalide and hyperbaric oxygen therapy on cognitive dysfunction in patients with delayed encephalopathy after acute carbon monoxide poisoning[J]. Med Sci Monit, 2017, 29(23):1501-1506.
[17]王春艺,李刚,王军,等.脑血管二氧化碳反应性研究进展[J].中华医学杂志, 2016, 96(18):1470-1472.
[18] Wang X L, Wang Z Y, Ling J J, et al. Synthesis and biological evaluation of nitric oxide(NO)-hydrogen sulfide(H(2)S)releasing derivatives of(S)-3-nbutylphthalide as potential antiplatelet agents[J]. Chin J Nat Med, 2016, 14(12):946-953.
[19]袁端华,林小慧,蒋丽丽,等.颈内动脉狭窄患者的CO2反应性、脑电图及血清CRP研究[J].现代电生理学杂志, 2017, 24(1):7-11, 14.
[20] Yan H, Yan Z, Niu X, et al. Dl-3-n-butylphthalide can improve the cognitive function of patients with acute ischemic stroke:a prospective intervention study[J].Neurol Res, 2017, 39(4):337-343.
[21]郑进,石进,陈大伟,等.颈动脉支架植入术对颈内动脉狭窄患者脑血流量及脑血管反应性的影响[J].中华神经医学杂志, 2017, 16(8):816-820.
[22] Chen X, Wang K. The fate of medications evaluated for ischemic stroke pharmacotherapy over the period 1995-2015[J]. Acta Pharm Sin B, 2016, 6(6):522-530.
[23] Zhang P, Guo Z F, Xu Y M, et al. N-Butylphthalide(NBP)ameliorated cerebral ischemia reperfusion-induced brain injury via HGF-regulated TLR4/NF-κB signaling pathway[J]. Biomed Pharmacother, 2016, 10(83):658-666.
[2] Liu R Z, Fan C X, Zhang Z L, et al. Effects of Dl-3-nbutylphthalide on cerebral ischemia infarction in rat model by mass spectrometry imaging[J]. Int J Mol Sci,2017, 18(11):E2451.
[3]丁笑笑,石进,马潞娜.单侧大脑中动脉狭窄患者脑血管储备力的评估[J].中华神经医学杂志, 2014, 13(2):188-190.
[4] Tang S C, Luo C J, Zhang K H, et al. Effects of dl-3-nbutylphthalide on serum VEGF and bFGF levels in acute cerebral infarction[J]. Eur Rev Med Pharmacol Sci,2017, 21(19):4431-4436.
[5] Tian Z, Wang J, Wang Y, et al. Effects of butylphthalide on cognitive decline in diabetic rats[J]. Mol Med Rep,2017, 16(6):9131-9136.
[6] Li J, Xu S F, Peng Y, et al. Conversion and pharmacokinetics profiles of a novel pro-drug of 3-nbutylphthalide, potassium 2-(1-hydroxypentyl)-benzoate,in rats and dogs[J]. Acta Pharmacol Sin, 2018, 39(2):275-285.
[7] Xiong Z, Lu W, Zhu L, et al. Dl-3-n-butylphthalide treatment enhances hemodynamics and ameliorates memory deficits in rats with chronic cerebral hypoperfusion[J]. Front Aging Neurosci, 2017, 26(9):238.
[8]郭晓敏,陈瑞莉,李鹏,等. MCA供血区急性脑梗死SWI图像与脑血管反应性的相关性[J].现代生物医学进展, 2016, 16(28):5479-5482.
[9] Zhang C, Zhao S, Zang Y, et al. The efficacy and safety of Dl-3n-butylphthalide on progressive cerebral infarction:A randomized controlled STROBE study[J].Medicine(Baltimore), 2017, 96(30):e7257.
[10] Tian X, He W, Yang R, et al. Dl-3-n-butylphthalide protects the heart against ischemic injury and H9c2cardiomyoblasts against oxidative stress:involvement of mitochondrial function and biogenesis[J]. J Biomed Sci,2017, 24(1):38.
[11] Sun Y, Cheng X, Wang H, et al. dl-3-n-butylphthalide promotes neuroplasticity and motor recovery in stroke rats[J]. Behav Brain Res, 2017, 30(329):67-74.
[12]韩献军,黄红莉,单树崇.磁敏感加权成像毛刷征与急性缺血性卒中患者血管反应性的关系[J].国际脑血管病杂志, 2014, 22(2):99-104.
[13] Li J, Wang X L, Wang A P, et al. Toxicokinetics and toxicity of potassium 2-(1-hydroxypentyl)-benzoate in beagle dogs[J]. J Asian Nat Prod Res, 2017, 19(4):388-401.
[14] Zhao Y, Lee J H, Chen D, et al. DL-3-n-butylphthalide induced neuroprotection, regenerative repair, functional recovery and psychological benefits following traumatic brain injury in mice[J]. Neurochem Int, 2017, 12(111):82-92.
[15]高宇海,石进,张英谦,等.症状性大脑中动脉狭窄患者支架置入术对脑血管反应性的影响[J].中华老年心脑血管病杂志, 2017, 19(2):126-129.
[16] Xiang W, Xue H, Wang B, et al. Efficacy of Nbutylphthalide and hyperbaric oxygen therapy on cognitive dysfunction in patients with delayed encephalopathy after acute carbon monoxide poisoning[J]. Med Sci Monit, 2017, 29(23):1501-1506.
[17]王春艺,李刚,王军,等.脑血管二氧化碳反应性研究进展[J].中华医学杂志, 2016, 96(18):1470-1472.
[18] Wang X L, Wang Z Y, Ling J J, et al. Synthesis and biological evaluation of nitric oxide(NO)-hydrogen sulfide(H(2)S)releasing derivatives of(S)-3-nbutylphthalide as potential antiplatelet agents[J]. Chin J Nat Med, 2016, 14(12):946-953.
[19]袁端华,林小慧,蒋丽丽,等.颈内动脉狭窄患者的CO2反应性、脑电图及血清CRP研究[J].现代电生理学杂志, 2017, 24(1):7-11, 14.
[20] Yan H, Yan Z, Niu X, et al. Dl-3-n-butylphthalide can improve the cognitive function of patients with acute ischemic stroke:a prospective intervention study[J].Neurol Res, 2017, 39(4):337-343.
[21]郑进,石进,陈大伟,等.颈动脉支架植入术对颈内动脉狭窄患者脑血流量及脑血管反应性的影响[J].中华神经医学杂志, 2017, 16(8):816-820.
[22] Chen X, Wang K. The fate of medications evaluated for ischemic stroke pharmacotherapy over the period 1995-2015[J]. Acta Pharm Sin B, 2016, 6(6):522-530.
[23] Zhang P, Guo Z F, Xu Y M, et al. N-Butylphthalide(NBP)ameliorated cerebral ischemia reperfusion-induced brain injury via HGF-regulated TLR4/NF-κB signaling pathway[J]. Biomed Pharmacother, 2016, 10(83):658-666.