丁苯酞联合阿替普酶治疗急性缺血性脑梗死的临床研究

目的观察丁苯酞氯化钠注射液、丁苯酞软胶囊联合注射用阿替普酶治疗急性缺血性脑梗死的临床疗效。方法选取2013年10月—2016年3月在潍坊市中医院的缺血性脑梗死患者60例作为研究对象,所有患者随机分为对照组和治疗组,每组各30例。对照组给予注射用阿替普酶0.9 mg/kg,首先1 min内静脉推注总量的10%,然后60 min静脉泵入剩余90%,最大剂量90 mg。治疗组在对照组基础上静脉滴注丁苯酞氯化钠注射液100 m L/次,2次/d,连续治疗14 d,然后改为口服丁苯酞软胶囊0.2 g/次,3次/d,连续治疗90 d。观察两组的临床疗效,比较两组的美国国立卫生研究院卒中量表(NIHSS)评分和血清基质金属蛋白酶-9(MMP-9)水平情况。结果治疗后,对照组和治疗组的总有效率分别为83.3%、93.3%,两组比较差异有统计学意义(P0.05)。治疗7、14、90 d后,两组NIHSS评分均显著下降,同组治疗前后比较差异有统计学意义(P0.05);且同期治疗组这些观察指标的下降程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗7、14 d后,两组MMP-9水平均显著下降,同组治疗前后比较差异有统计学意义(P0.05);且同期治疗组这些观察指标的下降程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论丁苯酞氯化钠注射液、丁苯酞软胶囊联合注射用阿替普酶治疗急性缺血性脑梗死具有较好的临床疗效,可改善神经功能损伤,降低血清MMP-9水平,具有一定的临床推广应用价值。

Clinical study on butylphthalide combined with alteplase in treatment of acute ischemic cerebral infarction

Objective To observe the clinical effect of Butylphthalide and Sodium Chloride Injection and Butylphthalide Soft Capsules combined with Alteplase for injection in treatment of acute ischemic cerebral infarction. Methods Patients (60 cases) with acute ischemic cerebral infarction in Weifang Traditional Chinese Hospital from October 2013 to March 2016 were randomly divided into control and treatment groups, and each group had 30 cases. Patients in the control group were given Alteplase for injection 0.9 mg/kg, first of all, intravenous bolus total dose 10% within 1 min, then 60 min intravenous infusion of the remaining 90%, the maximum dose 90 mg. Patients in the treatment group were iv administered with Butylphthalide and Sodium Chloride Injection on the basis of the control group, 100 mL/time, twice daily, treated for 14 d, then changed to po administered with Butylphthalide Soft Capsules, 0.2 g/time, three times daily, and were treated for 90 d. After treatment, the clinical efficacies were evaluated, and NHISS scores and serum MMP-9 levels in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 83.3% and 93.3%, respectively, and there was difference between two groups (P<0.05). After treatment for 7, 14, and 90 d, the NIHSS scores in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment for 7 and 14 d, the MMP-9 levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Butylphthalide and Sodium Chloride Injection and Butylphthalide Soft Capsules combined with Alteplase for injection has clinical curative effect in treatment of acute ischemic cerebral infarction, can improve nerve function damage, decrease serum MMP-9 levels, which has a clinical application value.