丁苯酞联合奥扎格雷钠治疗急性重症脑梗死患者临床效果

王艳茹 周国亮 张月婵 白凤英 宋桂菊

[摘要] 目的 探討丁苯酞联合奥扎格雷钠治疗急性重症脑梗死患者临床效果。 方法 回顾性分析2014年1月～2016年1月衡水市冀州区医院收治的204例急性重症脑梗死患者资料，依据临床治疗方法分为观察组（120例）与对照组（84例）。对照组患者予以基础治疗联合奥扎格雷钠，观察组在对照组基础上联合丁苯酞治疗，两组患者均治疗1周。观察两组患者治疗前后血清胆碱酯酶（CHE）、白细胞介素-6（IL-6）及心电图变化，采用美国国立卫生研究院神功功能缺损程度（NIHSS）评分与格拉斯哥昏迷（GCS）评分比较两组患者临床疗效。 结果 治疗后，两组的GCS评分、CHE水平较治疗前明显升高（P < 0.05），NIHSS评分及IL-6水平较治疗前明显降低（P < 0.05），且观察组治疗后的GCS评分、CHE水平明显高于对照组，NIHSS评分及IL-6水平明显低于对照组（P < 0.05）。治疗后，观察组患者的异常心电图变化率明显低于对照组（P < 0.05）。 结论 丁苯酞联合奥扎格雷钠治疗急性重症脑梗死可有效升高血清CHE，下调血清IL-6水平，降低心电图异常发生率，对于神经功能缺损程度改善有良好效果。

[关键词] 丁苯酞；奥扎格雷钠；急性脑梗死；胆碱酯酶；心电图

[中图分类号] R743.3 [文献标识码] A [文章编号] 1673-7210（2018）05（c）-0123-04

Clinical efficacy of Butylphthalide combined with Sodium Ozagrel in treating acute severe cerebral infarction

WANG Yanru ZHOU Guoliang▲ ZHANG Yuechan BAI Fengying SONG Guijü

The Second Medical Department， Jizhou District Hospital， Hengshui City， Hebei Province， Hengshui 053200， China

[Abstract] Objective To investigate the clinical efficacy of Butylphthalide combined with Sodium Ozagrel in the treatment of acute severe cerebral infarction. Methods In this study， 204 patients with acute severe cerebral infarction treated in the Jizhou District Hospital from January 2014 to January 2016 were analyzed retrospectively. They were divided into observation group （120 cases） and control group （84 cases） according to clinical treatment methods. Patients in the control group were treated with basic treatment combined with Sodium Ozagrel， while patients in the observation group were treated with Butylphthalide based on the control group. They were treated for 1 week. The serum cholinesterase （CHE）， interleukin-6 （IL-6） and the rate of ECG change before and after treatment were observed. The national institutes of health （NIHSS） score and Glasgow coma （GCS） were wsed to compare the clinical efficacy of the two groups. Results After treatment， the GCS scores and CHE levels were increased （P < 0.05）， NIHSS scores and the IL-6 levels were decreased （P < 0.05）， while the improvement of the observation group was more remarkable than control group （P < 0.05）. Besides， the rate of abnormal ECG change was lower than that of the control group （P < 0.05）. Conclusion The combination of Butyphthalide and Sodium Ozagrel in treating acute severe cerebral infarction can effectively increase the serum cholinesterase level， down-regulate the level of IL-6， reduce the incidence of ECG abnormalities and improve the curative effect of neurological deficits.

[Key words] Butylphthalide Injection； Sodium ozagrel； Acute cerebral infarction； Cholinesterase； Electrocardiogram

急性脑梗死（ACI）患者多伴有不同程度神经功能障碍，其中重症脑梗死发病后多伴有全身炎性反应及继发多脏器功能损伤[1]。积极溶栓、抗凝，恢复脑组织血供，挽救缺血半暗带，维持正常脑功能是ACI治疗的关键。但对于重症脑梗死患者，其治疗效果尚待提高[2]。丁苯酞注射液是临床常用血管扩张药物之一，可改善缺血半暗帶脑组织血液灌注[3]。奥扎格雷钠为选择性血栓素合成酶抑制剂，具有抗血小板聚集以及解除脑血管痉挛作用[4]。本文将从血清胆碱酯酶（CHE）、白细胞介素-6（IL-6）水平改变与心电图变化角度，分析丁苯酞联合奥扎格雷钠治疗急性重症脑梗死的临床效果，现将结果报道如下：

1 资料与方法