[1]易慧芳,白伟利.丁苯酞治疗颈内动脉系统脑分水岭梗死疗效观察[J].新乡医学院学报,2022,39(10):968-971.[doi:10.7683/xxyxyxb.2022.10.013]
 YI Huifang,BAI Weili.Effect of butylphthalide on cerebral watershed infarction of internal carotid artery system[J].Journal of Xinxiang Medical University,2022,39(10):968-971.[doi:10.7683/xxyxyxb.2022.10.013]
点击复制

丁苯酞治疗颈内动脉系统脑分水岭梗死疗效观察
分享到:

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
39
期数:
2022年10
页码:
968-971
栏目:
临床研究
出版日期:
2022-10-05

文章信息/Info

Title:
Effect of butylphthalide on cerebral watershed infarction of internal carotid artery system
作者:
易慧芳1白伟利2
(1.河南省军区郑州第三离职干部休养所,河南 郑州 450000;2.浏阳市集里医院神经内科,湖南 浏阳 410300 )
Author(s):
YI Huifang1BAI Weili2
(1.The Third Retirement Center for Retired Cadres of Zhengzhou,Henan Provincial Military Command,Zhengzhou 450000,Henan Province,China;2.Department of Neurology,Jili Hospital of Liuyang City,Liuyang 410300,Hunan Province,China)
关键词:
丁苯酞分水岭梗死临床疗效神经功能缺损
Keywords:
butylphthalidecerebral watershed infarctionclinical efficacyneurological deficits
分类号:
R743.33
DOI:
10.7683/xxyxyxb.2022.10.013
文献标志码:
A
摘要:
目的 探讨丁苯酞治疗颈内动脉系统脑分水岭梗死(CWI)的临床疗效。方法 选择2021年1月至2021年12月于浏阳市集里医院住院治疗的颈内动脉系统CWI患者80例为研究对象,根据治疗方法将患者分为对照组和观察组,每组40例。2组患者均积极辅助神经康复治疗,控制血糖、高脂血症等血管病危险因素,根据病情酌情控制血压。对照组患者给予常规治疗,包括:口服硫酸氢氯吡格雷片75 mg、阿司匹林肠溶片100 mg、阿托伐他汀钙片20 mg,每日1次;静脉注射羟乙基淀粉500 mL,每日1次。在对照组患者治疗基础上,观察组患者给予丁苯酞注射液100 mL,静脉滴注,每日2次。2组患者均连续治疗14 d。分别于治疗前及治疗7、14 d后采用美国国立卫生研究院卒中量表(NIHSS)评估2组患者的脑神经功能,治疗14 d后评估2组患者的临床疗效,并计算总有效率,治疗后3个月采用改良Rankin量表(mRS)评估2组患者的预后情况。结果 治疗前2组患者的NIHSS评分比较差异无统计学意义(P>0.05);2组患者治疗7、14 d后的NIHSS评分显著低于治疗前,治疗14 d后的NIHSS评分显著低于治疗 7 d后(P<0.05);治疗7、14 d后,观察组患者的NIHSS评分显著低于对照组(P<0.05)。治疗14 d后,对照组和观察组患者的有效率分别为 65.0%(26/40)和90.0%(36/40),观察组患者的有效率显著高于对照组(χ2=7.168,P<0.05)。治疗后3个月,观察组患者的mRS评分显著低于对照组(P<0.05)。结论 丁苯酞治疗颈内动脉系统CWI患者临床疗效较好,可促进患者神经功能恢复,改善预后。
Abstract:
Objective To investigate the clinical efficacy of butylphthalide in the treatment of patients with cerebral watershed infarction (CWI) of internal carotid artery system.Methods A total of 80 patients with CWI of the internal carotid artery system who were hospitalized in Jili Hospital of Liuyang City from January 2021 to December 2021 were selected as the research subjects.According to the treatment method,the patients were divided into the control group and the observation group,with 40 cases in each group.The patients in both groups were actively assisted with neurorehabilitation therapy,controlled blood sugar,hyperlipidemia and other risk factors of vascular disease,and controlled blood pressure as appropriate according to the condition.The patients in the control group were given conventional therapy,including oral clopidogrel hydrogen sulfate tablet 75 mg,aspirin enteric-coated tablet 100 mg,atorvastatin calcium tablet 20 mg,once a day;intravenous injection of hydroxyethyl starch 500 mL,once a day.On the basis of the treatment in the control group,the patients in the observation group were given intravenous drip of butylphthalide injection,100 mL each time,twice a day.The patients in the both groups received continuous treatment for 14 days.Before treatment and after 7,14 days of treatment,the cranial nerve function of patients in the two groups was evaluated by the National Institute of Health stroke scale (NIHSS).After 14 days of treatment,the clinical efficacy of patients in the two groups was evaluated,and the total effective rate was calculated.Three months after treatment,the prognosis of patients in the two groups was evaluated by the modified Rankin scale (mRS).Results Before treatment,there was no significant difference in the NIHSS scores of patients between the two groups (P>0.05).The NIHSS scores of patients in the two groups after 7 days and 14 days of treatment were significantly lower than those before treatment,and the NIHSS scores of patients in the two groups after 14 days of treatment were significantly lower than those after 7 days of treatment(P<0.05).After 7 days and 14 days of treatment,the NIHSS scores of patiens in the observation group were significantly lower than those in the control group(P<0.05).After 14 days of treatment,the effective rate of patients in the control group and the observation group was 65.0%(26/40) and 90.0%(36/40),respectively;the effective rate of patients in the observation group was significantly higher than that in the control group (χ2=7.168,P<0.05).After 3 months of treatment,the mRS score of patients in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Butylphthalide has a good clinical effect in the treatment of CWI of internal carotid artery system,which can promote the recovery of the patient′s neurological function and improve the prognosis.

参考文献/References:

[1] 冯静宇,王大力.脑分水岭梗死研究进展[J].河北联合大学学报(医学版),2014,16(2):196-197.
FEGN J Y,WANG D L.Research progress of brain watershed infarction[J].J Hebei Unit Univ (Health Sciences),2014,16(2):196-197.
[2] 钟利群,高颖,邹忆怀,等.颈内动脉系统分水岭梗死的影像学改变[J].中华全科医师杂志,2008,7(12):832-834.
ZHONG L Q,GAO Y,ZOU Y H,et al.Images of watershed infarctions in internal carotid artery[J].Chin J General Practit,2008,7(12):832-834.
[3] RENARD D,THOUVENOT E.Middle cerebral and anterior choroidal artery watershed infarction[J].Acta Neurol Belg,2013,114(1):67-68.
[4] 陈晓娟.进展性脑梗死的相关危险因素分析[J].中外医学研究,2021,19(2):17-21.
CHEN X J.Analysis of risk factors for progressive cerebral infarction[J].Chin Foreign Med Res,2021,19(2):17-21.
[5] 刘欣,李小刚,王红霞,等.老年轻型缺血性脑卒中早期进展的临床研究[J].中华老年心脑血管病杂志,2018,20(4):401-404.
LIU X,LI X G,WANG H X,et al.Early progression of mild ischemic stroke in the elderly[J].Chin J Geriatr Heart Brain Ves Dis,2018,20(4):401-404.
[6] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2018[J].中华神经科杂志,2018,51(9):666-682.
CHINESE MEDICAL ASSOCIATION NEUROLOGY BRANCH,CHINESE MEDICAL ASSOCIATION NEUROLOGY BRANCH CEREBROVASCULAR DISEASE GROUP.Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2018[J].Chin J Neurol,2018,51(9):666-682.
[7] ZAHARCHUK G,BAMMER R,STRAKA M,et al.Arterial spin-label imaging in patients with normal bolus perfusion-weighted MR imaging findings:pilot identification of the borderzone sign[J].Radiology,2009,252(3):797-807.
[8] ESKIOGLOU E,HUCHMANDZADEH MILLOTTE M,et al.National institutes of health stroke scale zero strokes[J].Stroke,2018,49(12):3057-3059.
[9] LEE S Y,KIM D Y,SOHN M K,et al.Determining the cut-off score for the modified barthel index and the modified rankin scale for assessment of functional independence and residual disability after stroke[J].PLoS One,2020,15(1):e0226324.
[10] BOGOUSSLAVSKY J,REGLI F.Unilateral watershed cerebral infarcts[J].Neurology,1986,36(3):373-377.
[11] LEE S P,HONG C T.Widespread watershed infarct in patient with malignancy-related hypercoagulation[J].Acta Neurol Taiwan,2012,2l(1):49-50.
[12] OTLUOGLU G D,AKAKIN A,DEMIR M K,et al.The surgical treatment of a large cortical atherosclerotic middle cerebral artery aneurysm presenting with parietal lobe infarction[J].J Craniofac Surg,2019,30(8):2597-2598.
[13] 中国老年医学学会急诊医学分会,中华医学会急诊医学分会卒中学组,中国卒中学会急救医学分会.急性缺血性脑卒中急诊急救中国专家共识 2018[J].中国卒中杂志,2018,13 (9):956-967.
CHINESE GERIATRICS ASSOCIATION EMERGENCY MEDICINE BRANCH,CHINESE MEDICAL ASSOCIATION EMERGENCY MEDICINE BRANCH STROKE GROUP,CHINESE STROKE SOCIETY EMERGENCY MEDICINE BRANCH.Chinese expert consensus on emergency first aid for acute ischemic stroke 2018[J].Chin J Stroke,2018,13(9):956-967.
[14] 乔利云,徐秀芝.心房纤颤患者急性分水岭区脑梗死的临床与影像学特点[J].国际老年医学杂志,2015,36(3):99-102.
QIAO L Y,XU X Z.Clinical and diffusion-weighted imaging features of acute border-zone infarction in the patients with atrial fibrillation[J].Intern J Geriatr,2015,36(3):99-102.
[15] 张颖,衣晶,秦鼎.进展性缺血性卒中脑血管造影31例分析[J].中西医结合心脑血管病杂志,2015,13(6):840-841.
ZHANG Y,YI J,QIN D.Analysis of 31 cases of progressive ischemic stroke cerebral angiography[J].Chin J Integrat Med Cardio/Cerebrov Dis,2015,13(6):840-841.
[16] 尤晓涵,杨淼,明霞光,等.盐酸川芎嗪注射液联合丁苯酞软胶囊治疗急性脑梗死疗效及对患者血液流变学影响[J].陕西中医,2020,41(6):743-745,757.
YOU X H,YANG M,MING X G,et al.Efficacy of ligustrazine hydrochloride injection combined with butylphthalide capsule in the treatment of acute cerebral infarction and the effect of hemorheology[J].Shaanxi J Trad Chin Med,2020,41(6):743-745,757.
[17] WANG Y,BI Y,XIA Z,et al.Butylphthalide ameliorates experimental autoimmune enecphalomyelitis by suppressing PGAM5 induced necroptosis and inflammation in microglial[J].Biophys Res Commun,2018,497(1):80-86.
[18] 邹蔷薇,王惠婕,何欣,等.局部亚低温联合丁苯酞注射液治疗对急性脑梗死患者细胞凋亡及斑块稳定性的影响[J].疑难病杂志,2019,18(11):1099-1102,1107.
ZOU Q W,WANG H J,HE X,et al.Effect of local mild hypothermia combined with butylphthalide injection on apoptosis and plaque stability in patients with acute cerebral infarction[J].Chin J Diffic Compl Cas,2019,18(11):1099-1102,1107.
[19] 邬刚,李建辉,战丽萍,等.丁苯酞注射液对伴有认知障碍的脑梗死急性期患者脑血流灌注和认知功能的影响[J].中华神经医学杂志,2018,17(5):484-490.
WU G,LI J H,ZHAN L P,et al.Effects of butylphthalide injection on cerebral blood flow perfusion and cognitive function in patients with acute cerebral infarction accompanied by cognitive disorder[J].Chin J Neuromed,2018,17(5):484-490.
[20] DA ROS PERUCH B,MONTEIRO B L,AIRES R,et al.Low doses of G-CSF prevent cerebral infarction and maintain muscle strength in an experimental model of global ischemic stroke[J].Curr Pharm Biotechnol,2018,19(6):514-519.
[21] 宋友,程鹏飞,董淑欣.丁苯酞对分水岭梗死患者 VEGF 及血流动力学的影响[J].黑龙江医药科学,2020,43(6):14-15.
SONG Y,CHEN P F,DONG S X.Effects of butylphthalide on VEGF and hemodynamics in patients with watershed infarction[J].Heilongjiang Med Pharm,2020,43(6):14-15.

相似文献/References:

[1]孙治坤,马兴荣,陈 帅,等.丁苯酞对糖尿病合并阿尔茨海默病大鼠记忆能力的影响[J].新乡医学院学报,2021,38(2):112.[doi:10.7683/xxyxyxb.2021.02.003]
 SUN Zhikun,MA Xingrong,CHEN Shuai,et al.Effect of butylphthalide on the memory ability of rats with diabetes mellitus and Alzheimer′s disease[J].Journal of Xinxiang Medical University,2021,38(10):112.[doi:10.7683/xxyxyxb.2021.02.003]
[2]徐国卫,杨亚红,常小敬,等.丁苯酞治疗大脑中动脉狭窄所致急性脑梗死疗效观察[J].新乡医学院学报,2020,37(5):481.[doi:10.7683/xxyxyxb.2020.05.019]
 XU Guowei,YANG Yahong,CHANG Xiaojing,et al.Clinical effect of butylphthalide for acute cerebral infarction caused by middle cerebral artery stenosis[J].Journal of Xinxiang Medical University,2020,37(10):481.[doi:10.7683/xxyxyxb.2020.05.019]
[3]陈 娟.丁苯酞对急性脑梗死患者神经功能及血清S100B、同型半胱氨酸和血管生成素-1水平的影响[J].新乡医学院学报,2018,35(6):498.[doi:10.7683/xxyxyxb.2018.06.012]
 CHEN Juan.Effect of butylphthalide on the neurological function and the levels of serum S100B,homocysteine,angiopoietin-1 in patients with acute cerebral infarction[J].Journal of Xinxiang Medical University,2018,35(10):498.[doi:10.7683/xxyxyxb.2018.06.012]
[4]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.[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(10):586.[doi:10.7683/xxyxyxb.2017.07.008]
[5]张 赟,郭艳平,张向东.丁苯酞静脉注射序贯口服治疗血管性认知障碍伴高同型半胱氨酸血症疗效观察[J].新乡医学院学报,2022,39(6):552.[doi:10.7683/xxyxyxb.2022.06.011]
 ZHANG Yun,GUO Yanping,ZHANG Xiangdong.Efficacy of butylphthalide intravenously and sequentially oral in the treatment of vascular cognitive impairment with hyperhomocysteinemia[J].Journal of Xinxiang Medical University,2022,39(10):552.[doi:10.7683/xxyxyxb.2022.06.011]

更新日期/Last Update: 2022-10-05