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丁苯酞联合血栓通对脑梗死患者血清炎症因子及预后影响的临床研究

Clinical study of Butylphthalide combined with Xue Shuan Tong on serum inflammatory factors and prognosis effect of patients with cerebral infarction.

作者信息

Du Ran, Teng Jun Fang, Wang Yan, Zhao Xin Yu, Shi Zhao Bo

机构信息

The First Affiliated Hospital of Zhengzhou University, Zhengzhou City, Henan Province, China.

出版信息

Pak J Pharm Sci. 2015 Sep;28(5 Suppl):1823-7.

Abstract

To investigate the effect of Butylphthalide and Xue Shuan Tong on serum inflammatory factors and prognosis of patients with cerebral infarction. One hundred and twenty patients with acute cerebral infarction were randomly divided into control group, Butylphthalide group and Xue Shuan Tong group, with 40 patients in each group. Conventional therapy was performed in the control group; On the basis of conventional therapy, 100ml Butylphthalide intravenously twice a day was administrated among patients in Butylphthalide group; On the basis of conventional therapy, 250ml 0.9% NaCl intravenously once a day was conducted among patients in Xue Shuan Tong group. A treatment course of continuous 7 days was taken in the three groups. The serum levels of IL-2 and CGRP were detected for patients in the three groups before and after treatment. Carotid plaque thickness and size as well as intima-media thickness were detected by ultrasonic testing for patients in three groups before treatment and 90 days after follow-up. The NIHSS, Barthel and MRS scoring were performed for all the patients after 90-day follow-up to evaluate the prognosis. After treatment, differences in the levels of IL-2 and CGRP for patients in the three groups showed statistical significance (P<0.05), while the levels of IL-2 and CGRP in Xue Shuan Tong group were significantly higher than those in the other two groups (P<0.05). After 7-day treatment, plaque size and thickness in Xue Shuan Tong group and Butylphthalide group were significantly reduced, compared with those before treatment (P<0.05), but no significant differences was shown in the plaque size and thickness between Xue Shuan Tong group and Butylphthalide group (P>0.05) .The CA-IMT in Xue Shuan Tong group and Butylphthalide group was significantly reduced after treatment, and that in Butylphthalide group was significantly larger than that in Xue Shuan Tong group (P<0.05). After 90-day follow-up, NIHSS scores in Butylphthalide group were significantly less than those in the other two groups (P<0.05). After 90-day follow-up, Barthel scores in Butylphthalide group and Xue Shuan Tong group were significantly larger than those in control group (P<0.05), while differences between Butylphthalide group and Xue Shuan Tong group indicated no statistical significance (P>0.05). There were significant differences in MRS scores among patients in the three groups after 90-day follow-up (P<0.05). Butylphthalide and Xue Shuan Tong are clinically effective in treating acute cerebral infarction. Butylphthalide has significant efficacy in inhibiting inflammation and improving prognosis of neurological function, while Xue Shuan Tong has obvious effect in improving carotid intima-media thickness.

摘要

探讨丁苯酞与血栓通对脑梗死患者血清炎症因子及预后的影响。将120例急性脑梗死患者随机分为对照组、丁苯酞组和血栓通组,每组40例。对照组给予常规治疗;丁苯酞组在常规治疗基础上,给予丁苯酞100ml静脉滴注,每日2次;血栓通组在常规治疗基础上,给予0.9%氯化钠250ml静脉滴注,每日1次。三组均连续治疗7天为1个疗程。检测三组患者治疗前后血清白细胞介素-2(IL-2)、降钙素基因相关肽(CGRP)水平。采用超声检测三组患者治疗前及随访90天后颈动脉斑块厚度、大小及内膜中层厚度。随访90天后对所有患者进行美国国立卫生研究院卒中量表(NIHSS)、巴氏指数(Barthel)及改良Rankin量表(MRS)评分,评估预后。治疗后,三组患者IL-2、CGRP水平差异有统计学意义(P<0.05),且血栓通组IL-2、CGRP水平显著高于其他两组(P<0.05)。治疗7天后,血栓通组和丁苯酞组斑块大小及厚度较治疗前显著减小(P<0.05),但血栓通组与丁苯酞组斑块大小及厚度比较差异无统计学意义(P>0.05)。治疗后,血栓通组和丁苯酞组颈动脉内膜中层厚度(CA-IMT)显著减小,且丁苯酞组CA-IMT大于血栓通组(P<0.05)。随访90天后,丁苯酞组NIHSS评分显著低于其他两组(P<0.05)。随访90天后,丁苯酞组和血栓通组Barthel评分显著高于对照组(P<0.05),但丁苯酞组与血栓通组比较差异无统计学意义(P>0.05)。随访90天后,三组患者MRS评分差异有统计学意义(P<0.05)。丁苯酞与血栓通治疗急性脑梗死临床疗效显著。丁苯酞在抑制炎症及改善神经功能预后方面疗效显著,而血栓通在改善颈动脉内膜中层厚度方面效果明显。

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