摘要
目的探讨丁苯酞联合抗血小板治疗对急性腔隙性脑梗死患者血管内皮功能、神经功能与炎症反应的影响。方法前瞻性选取2024年5月至2025年6月安徽医科大学第一附属医院东区收治的104例急性腔隙性脑梗死患者,按照随机数字表法将其分为两组,各52例。对照组给予常规抗血小板治疗,观察组在对照组基础上给予丁苯酞治疗,疗程10 d。比较两组治疗前及治疗10 d后的血管内皮功能指标(内皮素、一氧化氮)水平,治疗前及治疗3、5、10 d后神经功能情况[美国国立卫生研究院神经功能缺损评分量表(NIHSS)评分],并检测治疗前、治疗10 d后炎症因子[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)]水平,并观察两组不良反应发生情况。结果治疗10 d后,两组患者的内皮素水平低于治疗前,一氧化氮均高于治疗前,且观察组内皮素水平为(43.22±10.36)pg/mL,低于对照组[(52.11±12.45)pg/mL],观察组一氧化氮水平为(70.11±15.46)μmol/L,高于对照组[(60.88±13.15)μmol/L],差异均有统计学意义(P<0.05)。两组治疗前及治疗3 d后的NIHSS评分比较,差异均无统计学意义(P>0.05)。治疗5、10 d后,观察组患者的NIHSS评分分别为(8.45±2.65)、(6.55±2.11)分,均低于对照组[(9.98±2.68)、(8.49±3.12)分],差异均有统计学意义(P<0.05)。治疗10 d后,两组hs-CRP、TNF-α、IL-6水平较治疗前均降低,且观察组hs-CRP、TNF-α、IL-6水平分别为(5.33±1.31)mg/L、(12.32±4.15)ng/L、(4.65±1.36)ng/L,均低于对照组[(11.36±1.51)mg/L、(15.25±4.99)ng/L、(7.99±1.51)ng/L],差异均有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论丁苯酞联合抗血小板治疗可有效改善急性腔隙性脑梗死患者的血管内皮功能损伤、神经功能缺损,减轻炎症反应,安全性良好。
Objective To investigate the effects of butylphthalide combined with antiplatelet therapy on vascular endothelial function,neurological function and inflammatory reaction in acute lacunar cerebral infarction.Methods A total of 104 patients with acute lacunar cerebral infarction admitted to the First Affiliated Hospital of Anhui Medical University from May 2024 to June 2025 were prospectively selected and divided into two groups according to the random number table method,with 52 cases in each group.The control group received routine antiplatelet therapy,and the observation group received butylphthalide combined with all the base of the control group.The course of therapy was 10 days.The levels of vascular endothelial function indexes(endothelin,nitric oxide)before treatment and after 10 days of treatment were compared between the two groups.The neurological deficits[National Institute of Health Stroke Scale(NIHSS)]before treatment and after 3,5 and 10 days of treatment,and the levels of inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)]before treatment and after 10 days of treatment were detected,and the incidence of adverse reactions in the two groups was observed.Results After 10 days of treatment,the levels of endothelin in the two groups were lower than those before treatment,and the levels of nitric oxide,brachial artery blood flow-mediated vasodilation rate and brachial artery diameter change rate after taking nitroglycerin were higher than those before treatment,and the level of endothelin in the observation group was(43.22±10.36)pg/mL,which was lower than that in the control group[(52.11±12.45)pg/mL],the level of nitric oxide in the observation group was(70.11±15.46)μmol/L,which was higher than that in the control group[(60.88±13.15)μmol/L],and the differences were statistically significant(P<0.05).There was no statistically significant difference in NIHSS score between the two groups before treatment and 3 days after treatment(P>0.05).After 5 and 10 days of treatment,the NIHSS scores of the observation group were(8.45±2.65)and(6.55±2.11)points,respectively,which were lower than those of the control group[(9.98±2.68)and(8.49±3.12)points],the differences were statistically significant(P<0.05).After 10 days of treatment,the levels of hs-CRP,TNF-αand IL-6 in the two groups were lower than those before treatment,and the levels of hs-CRP,TNF-αand IL-6 in the observation group were(5.33±1.31)mg/L,(12.32±4.15)ng/L and(4.65±1.36)ng/L,respectively,which were lower than those in the control group[(11.36±1.51)mg/L,(15.25±4.99)ng/L,(7.99±1.51)ng/L],the differences were statistically significant(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Butylphthalide combined with antiplatelet therapy improves vascular endothelial dysfunction,neurological deficits and reduce inflammatory response in acute lacunar cerebral infarction,with acceptable safety.
作者
阚晓飞
汪燕燕
张梅玲
杨家岭
KAN Xiaofei;WANG Yanyan;ZHANG Meiling(Department of Pharmacy,2 Medical Record Room,East District,the First Affiliated Hospital of Anhui Medical University,Hefei Anhui 231600,China)
出处
《临床和实验医学杂志》
2026年第6期564-568,共5页
Journal of Clinical and Experimental Medicine
基金
安徽省重点研究与开发项目(编号:2022e07020066)。
关键词
丁苯酞
抗血小板治疗
腔隙性脑梗死
血管内皮功能
神经功能
炎症因子
Butylphthalide
Antiplatelet therapy
Lacunar cerebral infarction
Vascular endothelial function
Neurological function
Inflammatory factors
