丁苯酞联合马来酸桂哌齐特对急性脑梗死患者脑血流及神经功能相关指标水平的影响

目的观察丁苯酞软胶囊联合马来酸桂哌齐特注射液对急性脑梗死患者脑血流、神经功能及炎性指标等的影响。方法选取2017年3月—2018年3月海南省干部疗养院/海南省老年病医院内科收治急性脑梗死患者100例,按照随机数字表法分为对照组和观察组,各50例。对照组给予马来酸桂哌齐特注射液治疗,观察组在此基础上给予丁苯酞软胶囊治疗。比较2组治疗效果;检测2组患者治疗前及治疗后14 d大脑中动脉(MCA)、大脑前动脉(ACA)血流速度及神经生长因子(NGF)、神经元特异性烯醇化酶(NSE)、脑源性神经营养因子(BDNF)、星形胶质源性蛋白(S100-β)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)、白介素-10(IL-10)、单核细胞趋化蛋白-1(MCP-1)水平,并比较ADL评分、NIHSS评分及治疗过程中不良反应。结果治疗后,观察组患者治疗总有效率显著高于对照组(96.00%vs.80.00%,χ²/P=6.061/0.014);2组患者治疗后MCA、ACA血流速度,血清NGF、BDNF、IL-10水平,ADL评分均高于治疗前,NSE、S100-β、TNF-α、CRP、MCP-1水平,NIHSS评分均低于治疗前(P<0.05);观察组患者治疗后MCA、ACA血流水平,血清NGF、BDNF、IL-10水平,ADL评分均高于对照组(t/P=4.450/0.001,4.317/0.001,3.315/0.001,10.420/0.001,6.274/0.001,7.507/0.001),NSE、S100-β、TNF-α、CRP、MCP-1水平,NIHSS评分均低于对照组(t/P=7.963/0.001,5.212/0.001,13.450/0.001,14.840/0.001,11.650/0.001,6.385/0.001)。结论丁苯酞软胶囊联合马来酸桂哌齐特注射液治疗急性脑梗死患者效果显著,能改善脑血流动力,通过调控NGF、NSE、BDNF水平,促进患者脑神经功能恢复,抑制炎性反应,达到治疗目的。

Effect of butylphthalide combined with cinepazide maleate on cerebral blood flow and neurological function related indexes in patients with acute cerebral infarction

Objective To observe the effects of butylphthalide soft capsule combined with Cinepazide maleate injection on cerebral blood flow,nerve function and inflammatory indexes in patients with acute cerebral infarction.Methods From March 2017 to March 2018,100 patients with acute cerebral infarction were admitted to the Department of Internal Medicine of Hainan Provincial Cadre Sanatorium/Hainan Provincial Geriatrics Hospital.According to the random number table,they were divided into control group and observation group,with 50 cases in each.The control group was treated with cinepazide maleate injection,and the observation group was treated with butylphthalide soft capsule on this basis.Comparison of the treatment effects of the two groups.The blood flow speed of the middle cerebral artery(MCA),anterior cerebral artery(ACA),nerve growth factor(NGF)and neuron-specific enolase(NSE)of the two groups before treatment and 14 days after treatment),brain-derived neurotrophic factor(BDNF),astrocyte-derived protein(S100-β),tumor necrosis factorα(TNF-α),C-reactive protein(CRP),interleukin 10(IL-10),monocytes Chemotactic protein 1(MCP-1)levels,and compare the ADL score,NIHSS score,and adverse reactions during treatment.Results After treatment,the total effective rate of treatment in the observation group was significantly higher than that in the control group(96.00%vs.80.00%,χ²/P=6.061/0.014).After treatment,the blood flow speed of MCA and ACA,serum NGF,BDNF,and IL-10 levels,ADL scores were higher than before treatment,NSE,S100-β,TNF-α,CRP,MCP-1 levels,and NIHSS scores were all lower than before treatment(P<0.05).MCA and ACA blood flow speed and serum levels of patients in the observation group after treatment NGF,BDNF,IL-10 levels,ADL scores are all higher than the control group(t/P=4.450/0.001,4.317/0.001,3.315/0.001,10.420/0.001,6.274/0.001,7.507/0.001),NSE,S100-β,The levels of TNF-α,CRP,MCP-1,and NIHSS scores were all lower than those of the control group(t/P=7.963/0.001,5.212/0.001,13.450/0.001,14.840/0.001,11.650/0.001,6.385/0.001).Conclusion Butylphthalide soft capsule combined with cinepazide maleate injection is effective in the treatment of patients with acute cerebral infarction.It can improve cerebral blood flow,promote the recovery of brain nerve function of patients and inhibit inflammatory reaction by regulating the levels of NGF,NSE and BDNF.To achieve the purpose of treatment.