序贯丁苯酞治疗联合双重抗血小板治疗急性脑梗死
Sequential butylphthalide therapy combined with dual antiplatelet therapy in the treatment of acute cerebral infarction.
作者信息
Wo Xuewen, Han Jinyan, Wang Jiajia, Wang Xinmin, Liu Xiaoying, Wang Zhonggong
机构信息
Xuewen Wo, Departments of Neurology, Binzhou People's Hospital, Shandong, 256610, China.
Jinyan Han, Departments of Neurology, Binzhou People's Hospital, Shandong, 256610, China.
出版信息
Pak J Med Sci. 2020 May-Jun;36(4):615-620. doi: 10.12669/pjms.36.4.1831.
OBJECTIVE
To observe the clinical efficacy of sequential butylphthalide therapy combined with dual antiplatelet therapy in the treatment of elderly patients with acute cerebral infarction (ACI).
METHODS
One hundred and twenty-two elderly patients with ACI who were admitted to the department of neurology of our hospital at May 2016-August 2018 were selected grouped into a control group and an observation group by random number table method, 61 in each group. On the basis of conventional treatment, the patients in the control group were given dual antiplatelet therapy (aspirin enteric-coated tablets + clopidogrel bisulfate tablets), while the patients in the observation group were given sequential butylphthalide therapy on the basis of the control group. The clinical effects of the two groups were compared after four weeks of treatment, and the changes of National Institutes of Health Stroke Scale (NIHSS), ADL score, plasma 3-mercaptopyruvate sulphurtransferase (3-MST) and Amyloid β (Aβ) levels and the occurrence of adverse reactions during treatment were recorded.
RESULTS
The clinical efficacy of the observation group was better than that of the control group (P<0.05). There was no significant difference in NIHSS and ADL scores between the two groups before treatment (P>0.05). After treatment, the NIHSS and ADL scores of the observation group were better than those of the control group (P<0.05). There was no significant difference in plasma levels of 3-MST and AB42 between the two groups before treatment (P>0.05). The level of plasma 3-MST in the observation group was higher than that in the control group, and the level of plasma Aβ42 was lower than that in the control group (P<0.05). No serious adverse reactions occurred during the treatment period in both groups.
CONCLUSION
Butylphthalide sequential therapy combined with dual antiplatelet therapy is effective in the treatment of elderly ACI. It can effectively improve the plasma level of 3-MST and decrease the plasma level of Aβ42, which is conducive to improving the living ability and neurological function of patients and has high safety.
目的
观察序贯丁苯酞疗法联合双联抗血小板疗法治疗老年急性脑梗死（ACI）患者的临床疗效。
方法
选取2016年5月至2018年8月我院神经内科收治的122例老年ACI患者，采用随机数字表法分为对照组和观察组，每组61例。在常规治疗基础上，对照组患者给予双联抗血小板疗法（阿司匹林肠溶片+硫酸氢氯吡格雷片），观察组患者在对照组基础上给予序贯丁苯酞疗法。治疗4周后比较两组临床疗效，记录美国国立卫生研究院卒中量表（NIHSS）、日常生活活动能力（ADL）评分、血浆3-巯基丙酮酸硫转移酶（3-MST）和淀粉样β蛋白（Aβ）水平变化及治疗期间不良反应发生情况。
结果
观察组临床疗效优于对照组（P<0.05）。治疗前两组NIHSS和ADL评分比较差异无统计学意义（P>0.05）。治疗后，观察组NIHSS和ADL评分优于对照组（P<0.05）。治疗前两组血浆3-MST和Aβ42水平比较差异无统计学意义（P>0.05）。观察组血浆3-MST水平高于对照组，血浆Aβ42水平低于对照组（P<0.05）。两组治疗期间均未发生严重不良反应。
结论
丁苯酞序贯疗法联合双联抗血小板疗法治疗老年ACI有效。可有效提高血浆3-MST水平，降低血浆Aβ42水平，有利于提高患者生活能力和神经功能，安全性高。
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