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丁苯酞联合阿替普酶对急性脑梗死患者神经功能、认知功能和Hcy等血清学指标的影响
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| 篇名： | 丁苯酞联合阿替普酶对急性脑梗死患者神经功能、认知功能和Hcy等血清学指标的影响 |
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| 摘要： | 目的：观察丁苯酞联合阿替普酶对急性脑梗死（ACI）患者神经功能、认知功能和同型半胱氨酸（Hcy）等血清学指标的影响。方法：回顾性分析2014年2月－2017年4月我院急诊科收治的78例ACI患者的临床资料，根据治疗方案将患者分为对照组及观察组，各39例。两组患者均给予常规治疗，同时口服阿司匹林肠溶片，对照组患者在此基础上给予注射用阿替普酶0.9 mg/kg静脉溶栓治疗，观察组患者在对照组基础上口服丁苯酞软胶囊0.2 g，tid。两组患者均连续治疗28 d。观察两组患者的临床疗效，治疗前及治疗后3、7、14、28 d时的美国国立卫生研究院卒中量表（NIHSS）及简易智力状况检查法（MMSE）评分，治疗前后Hcy、神经元特异性烯醇化酶（NSE）及6-酮-前列腺素-F1a（6-k-PGF1a）水平，并记录不良反应发生情况。结果：治疗后，观察组患者的总有效率为92.31％，显著高于对照组的71.79％，差异有统计学意义（P＜0.05）。治疗后3～28 d，两组患者的NIHSS评分均逐渐降低，且显著低于治疗前，MMSE评分均逐渐升高，且显著高于治疗前，差异均有统计学意义（P＜0.05或P＜0.01）；治疗后7～28 d，观察组患者的NIHSS评分显著低于对照组同期，MMSE评分显著高于对照组同期，差异均有统计学意义（P＜0.05或P＜0.01）。治疗后，两组患者的血清Hcy、NSE水平均显著降低，且观察组显著低于对照组，6-酮-前列腺素-F1a（6-k-PGF1a）水平均显著升高，且观察组显著高于对照组，差异均有统计学意义（P＜0.05或P＜0.01）。两组患者不良反应总发生率比较，差异无统计学意义（P＞0.05）。结论：丁苯酞联合阿替普酶可明显改善ACI患者神经功能缺损及认知障碍，降低其血清Hcy、NSE水平，升高6-k-PGF1a水平，临床疗效优于单用阿替普酶。 |
| ABSTRACT： | OBJECTIVE： To observe the effects of butylphthalide combined with alteplase on neural funetion and cognitive function and serological indexes as homocysteine （Hcy） in patients with acute cerebral infarction （ACI）. METHODS： Clinical information of 78 ACI patients in emergency department of our hospital during Feb. 2140-Apr. 2017 were analyzed and then divided into control group and observation group according to therapy plan， with 39 cases in each group. Both groups received conventional treatment and Aspirin enteric-coated tablets orally. Control group was given Alteplase for injection 0.9 mg/kg for verous thromblysis on the basis of conventional treatment. Observation group was additionally given Butyphthalide soft capsules 0.2 g orally， tid， on the basis of control group. Both groups were treated for consecutive 28 days. The clinical efficacies of 2 groups were observed. NIHSS and MMSE scores before treatment， 3， 7， 14 and 28 d after treatment， the levels of Hcy， NSE and 6-k-PGF1a were observed in 2 groups； the occurrence of ADR was recorded. RESULTS： After treatment， total response rate of observation group was 92.31％， which was significantly higher than 71.79％ of control group， with statistical significance （P＜0.05）. 3-28 d after treatment， NIHSS scores of 2 groups were decreased gradually and significantly lower than before treatment； MMSE scores of 2 groups were increased gradually and significantly higher than before treatment， with statistical significance （P＜0.05 or P＜0.01）. 7-28 d after treatment， NIHSS score of observation group was significantly lower than that of control group at same time， while MMSE score was significantly higher than control group， with statistical significance （P＜0.05 or P＜0.01）. After treatment， serum levels of Hcy and NSE in 2 groups were decreased significantly， and observation group was significantly lower than control group； the level of 6-k-PGF1a was increased significantly， and observation group was significantly higher than control group， with statistical significance （P＜0.05 or P＜0.01）. There was no statistical significantce in the total incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： Butylphthalide combined with alteplase can significantly improve neurologic impairment and cognitive function of ACI patients， reduce serum levels of Hcy and NSE and increase the level of 6-k-PGF1a. Clinical efficacy of it is significantly better than alteplase alone. |
| 期刊： | 2018年第29卷第8期 |
| 作者： | 朱烨，吴雅利，李宝香，何静 |
| AUTHORS： | ZHU Ye，WU Yali，LI Baoxiang，HE Jing |
| 关键字： | 急性脑梗死；丁苯酞；阿替普酶；神经认知；认知功能；同型半胱氨酸 |
| KEYWORDS： | Acute cerebral infarction； Butylphthalide； Alteplase； Neural function； Cognitive function； Homocysteine |
| 阅读数： | 196 次 |
| 本月下载数： | 3 次 |
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