丁苯酞联合长春西汀治疗急性脑梗死的疗效及对脑血流动力学和认知功能的影响

doi:10.3969/j.issn.1671-7171.2022.11.009

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摘要【目的】观察丁苯酞联合长春西汀治疗急性脑梗死(ACI)的疗效及对患者脑血流动力学和认知功能的影响。【方法】本院收治的120例ACI患者随机分为两组,每组60例。对照组给予长春西汀治疗,观察组在对照组基础上加用丁苯酞治疗,两组均治疗14 d。比较两组的临床疗效、美国国立卫生研究院卒中量表(NIHSS)评分、简明精神状态量表(MMSE)评分、脑血流动力学[双侧大脑中动脉的峰流速(V_p)、平均流速(V_m)、脑血管储备(CVR)]及血清同型半胱氨酸(Hcy)、6-酮-前列腺素-F1a(6-k-PGF1a)、血管内皮生长因子(VEGF)水平,并观察两组不良反应情况。【结果】观察组治疗总有效率高于对照组(P<0.05)。与治疗前比较,两组治疗后NIHSS评分降低,且观察组显著低于对照组,两组治疗后MMSE评分增高,且观察组显著高于对照组(P<0.05)。与治疗前比较,两组治疗后V_p、V_m及CVR增高,且观察组显著高于对照组(P<0.05)。与治疗前比较,两组治疗后Hcy呈降低趋势,且观察组显著低于对照组,两组治疗后6-k-PGF1a及VEGF水平呈增高趋势,且观察组显著高于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。【结论】丁苯酞联合长春西汀注射液治疗ACI疗效显著,且不会增加不良反应,其可能通过改善脑血流动力学、降低血清Hcy水平及升高血清6-k-PGF1a、VEGF水平等方式来促进神经功能及认知功能恢复。

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	张冬子
	陈斌

关键词 ：脑梗死/药物疗法, 急性病, 苯丙酮类/治疗应用, 长春花生物碱类/治疗应用, 血液流变学, 治疗结果

Abstract：【Objective】To observe the effects and safety of butylphthalide combined with vinpocetine on cerebral hemodynamics and cognitive function in the treatment of acute cerebral infarction(ACI)patients. 【Methods】A total of 120 ACI patients in our hospital were randomly divided into two groups with 60 cases in each group.The control group was given vinpocetine,while the observation group was given butylphthalide on the basis of the control group.Both groups were treated for 14 d.The clinical efficacy,NIHSS score,MMSE score,cerebral hemodynamics [peak flow velocity (V_p),average flow velocity (V_m),cerebrovascular reserve (CVR)] and serum homocysteine (Hcy),6-keto-prostaglandin-F1A (6-K-PGF1a) and VEGF were compared between the two groups. 【Results】The total effective rate of the observation group was higher than that of the control group ( P<0.05).Compared to before treatment,the NIHSS score of the two groups decreased after treatment; And NIHSS score of the observation group was significantly lower than that of the control group.After treatment,the MMSE score of the two groups increased and MMSE of the observation group was significantly higher than that of the control group (P<0.05).Compared with before treatment,Vp,V_m and CVR of the two groups showed an increasing trend after treatment,and those values in the observation group was significantly higher than those in the control group (P<0.05).Compared with before treatment,the Hcy of the two groups decreased after treatment,and the decreasing of the observation group was significantly lower than that of the control group.After treatment,the levels of 6-k-PGF1a and VEGF increased,and the increasing of the observation group was significantly higher than that of the control group (P<0.05).The incidence of adverse reactions in two group was not significantly different (P>0.05). 【Conclusion】Butylphthalide injection combined with vinpocetine injection have significant efficacy in the treatment of ACI,which can significantly improve cerebral hemodynamics,reduce the levels of Hcy,and increase the levels of 6-k-PGF1a and VEGF to promote the recovery of neural function and cognitive function,without increasing adverse drug reactions.

Key words： Brain Infarction/DT Acute Disease Propiophenones/TU Vinca Alkaloids/TU Hemorheology Treatment Outcome

收稿日期: 2021-12-22

中图分类号:

R743.33

基金资助:陕西省教育厅专项科研计划项目(13JK0787)

通讯作者: **E-mail:13700227662@126.com

引用本文:

张冬子, 陈斌. 丁苯酞联合长春西汀治疗急性脑梗死的疗效及对脑血流动力学和认知功能的影响[J]. 医学临床研究, 2022, 39(11): 1630-1633.
ZHANG Dong-zi, CHEN Bin. Effects of Butylphthalide Injection Combined with Vinpocetine Injection on Cerebral Hemodynamics and Cognitive Function of Patients with Acute Cerebral Infarction. JOURNAL OF CLINICAL RESEARCH, 2022, 39(11): 1630-1633.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2022.11.009 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2022/V39/I11/1630

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