早期应用丁苯酞联合低分子肝素、双联抗血小板聚集药物治疗急性穿支动脉病变型脑梗死的疗效及安全性分析

目的观察早期应用丁苯酞联合低分子肝素、双联抗血小板聚集药物治疗急性穿支动脉病变型脑梗死的疗效及安全性。方法503例急性穿支动脉病变型脑梗死患者,随机分为对照组(253例)和研究组(250例)。对照组患者给予低分子肝素、双联抗血小板聚集药物进行治疗,研究组在对照组基础上给予丁苯酞进行治疗。观察比较两组患者治疗前和治疗1、7 d后神经功能缺损程度,治疗前和治疗3个月后生活能力,不良反应发生情况。结果两组患者治疗1、7 d后美国国立卫生研究院卒中量表(NIHSS)评分均低于本组治疗前,差异具有统计学意义(P<0.05)。治疗1 d后,研究组NIHSS评分(14.63±1.34)分略低于对照组的(14.77±1.48)分,但差异无统计学意义(P>0.05);治疗7 d后,研究组患者NIHSS评分(8.03±1.54)分明显低于对照组的(11.56±2.01)分,差异具有统计学意义(P<0.05)。两组患者治疗3个月后改良RANKIN量表(mRS)评分均低于本组治疗前,差异具有统计学意义(P<0.05)。治疗3个月后,研究组患者mRS评分(0.98±0.34)分明显低于对照组的(1.77±0.48)分,差异具有统计学意义(P<0.05)。两组患者治疗过程中均无肠道出血等不良反应发生。结论早期应用丁苯酞联合低分子肝素、双联抗血小板聚集药物治疗急性穿支动脉病变型脑梗死患者,可有效改善患者的神经功能损伤状态,恢复患者生活能力,且安全性较好,具有较高的推广价值。

Efficacy and safety analysis of early application of butylphthalide combined with low-molecular-weight heparin and dual antiplatelet aggregation drugs in the treatment of acute perforating branch arterial cerebral infarction

Objective To observe the safety analysis of early application of butylphthalide combined with low-molecular-weight heparin and dual antiplatelet aggregation drugs in the treatment of acute perforating branch arterial cerebral infarction.Methods A total of 503 patients with acute perforating branch arterial cerebral infarction were randomly divided into control group(253 cases)and research group(250 cases).The control group was treated by low-molecular-weight heparin and dual antiplatelet aggregation drugs,and the research group was treated by butylphthalide on the basis of the control group.The degree of neurological deficit before and after 1 and 7 d of treatment,activities of daily living before treatment and after 3 months of treatment and occurrence of adverse reactions were compared between the two groups.Results After 1 and 7 d of treatment,National Institutes of Health stroke scale(NIHSS)score of the two groups were lower than those before treatment of the same group,and the difference was statistically significant(P<0.05).After 1 d of treatment,NIHSS score of the research group(14.63±1.34)points was a little lower than that of the control group(14.77±1.48)points,but the difference was not statistically significant(P>0.05).After 7 d of treatment,NIHSS score of the research group(8.03±1.54)points was obviously lower than that of the control group(11.56±2.01)points,and the difference was statistically significant(P<0.05).After 3 months of treatment,modified RANKIN scale(mRS)score of the two groups were lower than those before treatment of the same group,and the difference was statistically significant(P<0.05).After 3 months of treatment,mRS score of the research group(0.98±0.34)points was obviously lower than that of the control group(1.77±0.48)points,and the difference was statistically significant(P<0.05).No adverse reactions such as intestinal bleeding occurred during the treatment of the two groups.Conclusion For patients with acute perforating branch arterial cerebral infarction,early application of butylphthalide combined with low molecular weight heparin and dual antiplatelet aggregation drugs can effectively improve the state of neurological damage,restore the activities of daily living of patients with high safety,which contains a high promotional value.