丁苯酞联合低分子肝素钙治疗急性进展性脑梗死的效果观察

彭俊平

【摘要】 目的：觀察丁苯酞联合低分子肝素钙治疗急性进展性脑梗死的临床效果。方法：选取本院2016年7月-2017年10月期间住院治疗的87例急性进展性脑梗死患者作为研究对象，按照随机数字表法将其分为对照组（n=42）和观察组（n=45）。对照组在常规治疗措施上加用低分子肝素钙治疗，观察组在常规治疗措施上加用丁苯酞联合低分子肝素钙治疗。比较两组治疗总有效率，评估治疗前后神经功能缺损程度、日常生活能力变化情况，检测治疗前后血清白介素6（IL-6）、肿瘤坏死因子α（TNF-α）、同型半胱氨酸（Hcy）、神经元特异性烯醇化酶（NSE）表达水平。结果：观察组治疗总有效率为84.4%明显高于对照组的61.9%，差异有统计学意义（字2=3.492，P=0.017）。两组治疗前NIHSS、ADL评分比较，差异均无统计学意义（P>0.05）；治疗后，两组NIHSS评分明显低于治疗前，ADL评分明显高于治疗前；且观察组NIHSS评分明显低于对照组，ADL评分明显高于对照组，差异均有统计学意义（P<0.05）。两组治疗前血清IL-6、TNF-α、Hcy、NSE表达水平比较，差异均无统计学意义（P>0.05）。治疗后，两组血清IL-6、TNF-α、Hcy、NSE表达水平均明显低于治疗前；且观察组均明显低于对照组，差异均有统计学意义（P<0.05）。结论：丁苯酞联合低分子肝素钙治疗急性进展性脑梗死疗效显著，可明显改善患者神经功能缺损程度和日常生活能力，显著降低血清IL-6、TNF-α、Hcy、NSE表达水平。

【关键词】 丁苯酞； 低分子肝素钙； 急性进展性脑梗死

【Abstract】 Objective：To observe the clinical effect of Butylphthalide combined with Low Molecular Weight Heparin Calcium in the treatment of acute progressive cerebral infarction.Method：A total of 87 patients with acute progressive cerebral infarction hospitalized from July 2016 to October 2017 in our hospital were selected as study subjects.According to the random number table method，they were divided into control group （n=42） and observation group （n=45）.The control group was treated with Low Molecular Weight Heparin Calcium on the base of the conventional treatment，the observation group was treated with Butylphthalide combined with Low Molecular Weight Heparin Calcium on the base of the conventional treatment.The total effective rate of treatment between the two groups were compared，the degree of neurological impairment and daily living ability before and after treatment were evaluated，the expression levels of serum IL-6，TNF-α，Hcy，NSE before and after treatment were detected.Result：The total effective rate of treatment in the observation group was 84.4%，which was significantly higher than 61.9% in the control group，the difference was statistically significant（字2=3.492，P=0.017）.There were no significant differences in NIHSS and ADL scores between two groups before treatment （P>0.05）. After treatment， NIHSS score of the two groups was significantly lower than that before treatment， ADL score was significantly higher than that before treatment；and NIHSS score in the observation group was significantly lower than that in the control group， ADL score was significantly higher than that in the control group，the differences were statistically significant（P<0.05）.There were no significant differences in the expression levels of serum IL-6，TNF-α，Hcy and NSE between the two groups before treatment（P>0.05）.After treatment，the expression levels of serum IL-6，TNF-α，Hcy and NSE between two groups were significantly lower than those before treatment；and the observation group were significantly lower than those in the control group，the differences were statistically significant（P<0.05）.Conclusion：The treatment of Butylphthalide combined with Low Molecular Heparin Calcium for acute progressive cerebral infarction has a significant effect，it can significantly improve the degree of neurological impairment and daily living ability，and significantly reduce the expression levels of serum IL-6，TNF-α，Hcy and NSE.

【Key words】 Butylphthalide； Low Molecular Weight Heparin Calcium； Acute progressive cerebral infarction

First-authors address：Hanyang Hospital Affiliated to Wuhan University of Science and Technology，Wuhan 430050，China

doi：10.3969/j.issn.1674-4985.2018.18.015

急性进展性脑梗死是一种发病率较高的脑梗死疾病，近些年呈逐渐升高的趋势[1]。既往采用常规措施治疗难以取得理想的治疗效果[2]。相关研究证实，丁苯酞不但可显著增加脑缺血病灶组织的血流供应量，还可有效改善脑组织能量代谢生理功能[3]，最终明显减少脑梗死病灶面积，而低分子肝素钙常作为临床治疗急性脑梗死的抗血栓药物[4-5]。因……