[1]黄丽娟,张艳蕉,赵　亮,等.丁苯酞氯化钠注射液治疗中青年急性脑梗死疗效观察[J].新乡医学院学报,2017,34(7):586-589.[doi:10.7683/xxyxyxb.2017.07.008]
　HUANG Li-juan,ZHANG Yan-jiao,ZHAO Liang,et al.Efficacy of butylphthalide and sodium chloride injection in the treatment of young and middle aged patients with acute cerebral infarction[J].Journal of Xinxiang Medical University,2017,34(7):586-589.[doi:10.7683/xxyxyxb.2017.07.008]
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丁苯酞氯化钠注射液治疗中青年急性脑梗死疗效观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
34
期数:
2017年7
页码:
586-589
栏目:
临床研究
出版日期:
2017-07-05

文章信息/Info

Title:
Efficacy of butylphthalide and sodium chloride injection in the treatment of young and middle aged patients with acute cerebral infarction
作者:
黄丽娟; 张艳蕉; 赵　亮; 于广娜; 李　莉; 何　薇
（齐齐哈尔医学院附属第三医院神经内一科，黑龙江　齐齐哈尔　161000）
Author(s):
HUANG Li-juan; ZHANG Yan-jiao; ZHAO Liang; YU Guang-na; LI Li; HE Wei
（Department of Neurology，the Third Affiliated Hospital of Qiqihar Medical University，Qiqihar 161000，Heilongjiang Province，China）
关键词:
丁苯酞; 急性脑梗死; 中年; 青年; 血液流变学; 血管内皮功能
Keywords:
butylphthalide; acute cerebral infarction; middle age; youth; hemorheology; vascular endothelial function
分类号:
R743.33
DOI:
10.7683/xxyxyxb.2017.07.008
文献标志码:
A
摘要:
目的　探讨丁苯酞氯化钠注射液治疗中青年急性脑梗死（ACI）的临床效果。方法　选择2015年6月至2016年6月齐齐哈尔医学院附属第三医院收治的中青年ACI患者209例，按治疗方法将患者分为观察组（n=105）和对照组（n=104）。对照组患者给予ACI常规治疗，观察组患者在常规治疗基础上给予丁苯酞氯化钠注射液100 mL，静脉滴注，每日2次，连续治疗2周。分别于治疗前、治疗14 d后及治疗后3个月检测2组患者红细胞比容（Hct）、血浆纤维蛋白原（FIB）水平及血清中一氧化氮（NO）、内皮型一氧化氮合酶（eNOS）和D-二聚体（D-D）水平，采用美国国立研究院卒中量表（NIHSS）进行神经功能缺损评分，采用Barthel指数评定患者的日常生活活动能力，采用螺旋CT测患者脑梗死体积；并观察2组患者不良反应。结果　治疗前2组患者Hct、FIB、NO、eNOS及D-D水平比较差异均无统计学意义（P>0.05）。与治疗前比较，治疗14 d后及治疗后3个月2组患者Hct、FIB、D-D水平降低（P<0.05），NO和eNOS水平升高（P<0.05）；与治疗14 d后比较，治疗后3个月2组患者Hct、FIB、D-D水平降低（P<0.05），NO和eNOS水平升高（P<0.05）。治疗14 d后及治疗后3个月，观察组患者Hct、FIB、D-D水平显著低于对照组（P<0.05），NO和eNOS水平显著高于对照组（P<0.05）。治疗前2组患者脑梗死体积、NIHSS评分及Barthel指数比较差异均无统计学意义（P>0.05）。与治疗前比较，治疗14 d后及治疗后3个月2组患者脑梗死体积和 NIHSS 评分降低（P<0.05），Barthel指数升高（P<0.05）；与治疗14 d后比较，治疗后3个月2组患者脑梗死体积和NIHSS评分降低（P<0.05），Barthel指数升高（P<0.05）。治疗14 d后及治疗后3个月，观察组患者脑梗死体积和NIHSS评分显著低于对照组（P<0.05），Barthel指数显著高于对照组（P<0.05）。对照组和观察组患者治疗总有效率分别为81.7%（85/104）、91.4%（96/105），观察组患者治疗总有效率显著高于对照组（χ2=4.663，P<0.05）。对照组和观察组患者不良反应发生率分别为5.8%（6/104）、7.6%（8/105），2组患者不良反应发生率比较差异无统计学意义（χ2=0.281，P>0.05）。结论　丁苯酞可有效改善中青年ACI患者血液流变学、血管内皮功能、神经功能及日常生活活动能力。
Abstract:
Objective　To investigate the clinical effect of butylphthalide and sodium chloride injection in the treatment of young and middle aged patients with acute cerebral infarction （ACI）.Methods　A total of 209 young and middle aged patients with ACI were selected from June 2015 to June 2016 in the Third Hospital Affiliated to Qiqihar Medical University.The patients were divided into observation group （n=105） and control group （n=104） according to the treatment method.The patients in the control group were treated with routine treatment for ACI.Based on the routine treatment，the patients in the observation group were treated with butylphthalide and sodium chloride injection 100 mL by intravenous drip，twice a day for two weeks.The hematocrit （Hct），plasma fibrinogen （FIB） level，serum nitric oxide （NO），endothelial nitric oxide synthase （eNOS） and D-dipolymer （D-D） levels were detected in the two groups；the score of neurologic impairment was performed with the national institutes of health stroke scale （NIHSS）；the activity of daily living was evaluated by Barthel index；and the volume of cerebral infarction was measured by spiral CT at the time points of before treatment，after treatment of fourteen days and three months after treatment.The adverse reactions of the patients in the two groups were observed.Results　There was no significant difference in the levels of Hct,FIB,NO,eNOS and D-D between the two groups before treatment(P>0.05).Compared with pretherapy,the levels of Hct,FIB and D-D decreased(P<0.05);and the levels of NO and eNOS increased at the time points of 14 days and 3 months after treatment in the two groups(P<0.05).Compared with the treatment of 14 d,the levels of Hct,FIB and D-D decreased at the time point of 3 months after treatment(P<0.05);and the levels of NO and eNOS increased at the time point of 3 months after treatment in the two groups(P<0.05).The levels of Hct,FIB and D-D in the observation group were significantly lower than those in the control group(P<0.05),and the levels of NO and eNOS in the observation group were significantly higher than those in the control group at the time points of 14 days and 3 months after treatment(P<0.05).There was no significant difference in the volume of cerebral infarction,NIHSS score and Barthel index between the two groups before treatment(P>0.05).Compared with pretherapy,the volume of cerebral infarction and NIHSS score decreased(P<0.05);and the Barthel index increased at the time points of 14 days and 3 months after treatment in the two groups (P<0.05).Compared with the treatment of 14 d,the volume of cerebral infarction and NIHSS score decreased(P<0.05);and the Barthel index increased at the time point of 3 months after treatment in the two groups (P<0.05).The volume of cerebral infarction and NIHSS score in the observation group were significantly lower than those in the control group(P<0.05),and the Barthel index in the observation group was significantly higher than that in the control group at the time points of 14 days and 3 months after treatment (P<0.05).The total effective rate in the control group and the observation group was 81.7% (85/104) and 91.4% (96/105) respectively,the total effective rate in the observation group was significantly higher than that in the control group(χ2=4.663,P<0.05).The incidence of adverse reactions in the control group and the observation group was 5.8% (6/104) and 7.6% (8/105) respectively,there was no significant difference in the incidence of adverse reactions between the two groups (χ2=0.281,P>0.05).Conclusion　Butylphthalide can effectively improve the blood rheology，vascular endothelial function，nerve function and the activity of daily living in young and middle aged patients with ACI.

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更新日期/Last Update: 2017-07-05