丁苯酞序贯疗法对缺血性脑卒中患者神经功能缺损以及血清同型半胱氨酸和低密度脂蛋白胆固醇的影响
| 作者: |
1舒燕燕
1 池州市人民医院药剂科，安徽 池州 247000 |
| 通讯: |
舒燕燕
Email: 278581536@qq.com |
| DOI: | 10.3978/j.issn.2095-6959.2022.02.009 |
摘要
目的：探讨丁苯酞序贯疗法对缺血性脑卒中患者神经功能缺损以及血清同型半胱氨酸(homocysteine，Hcy)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol，LDL-C)的影响。方法：回顾性分析2020年1月至2021年3月池州市人民医院收治的120例缺血性脑卒中患者的相关资料，根据治疗方法不同分为对照组(64例)与研究组(56例)。对照组给予常规标准治疗，研究组另给予丁苯酞序贯疗法治疗。比较两组颅脑多普勒检查结果、卒中量表(NIH Stroke Scale，NIHSS)减分率、血清指标(Hcy、LDL-C)及近期预后状况。结果：研究组治疗7、14 d后脑动脉侧支循环开放率均高于对照组，治疗14、90 d后的NIHSS减分率高于对照组，治疗14 d后血清Hcy水平[(15.18±3.89) μmol/L]和LDL-C水平[(2.93±0.37) mmol/L]低于对照组[(18.24±4.16) μmol/L和(3.10±0.44) mmol/L]，上述差异均有统计学意义(P<0.05)。治疗14 d 后血清Hcy和LDL-C水平与NIHSS减分率均呈负相关(r=−0.725和−0.690，P<0.05)。研究组治疗90 d后的预后良好率(58.93%)高于对照组(39.06%)，差异有统计学意义(P<0.05)。接受丁苯酞序贯疗法是缺血性脑卒中患者治疗90 d后预后良好的保护因素[优势比(odds ratio，OR) =1.372，95%CI：1.103~1.579，P<0.05]。结论：丁苯酞序贯疗法能促进缺血性脑卒中患者的脑动脉侧支循环开放，降低血清Hcy和LDL-C水平，减轻神经功能缺损，且是近期预后良好的保护因素。
关键词：
缺血性脑卒中；丁苯酞；序贯疗法；神经功能；同型半胱氨酸；低密度脂蛋白胆固醇
Effect of butylphthalide sequential therapy on neurological deficit, serum homocysteine, and low-density lipoprotein cholesterol in patients with ischemic stroke
CorrespondingAuthor: SHU Yanyan Email: 278581536@qq.com
DOI: 10.3978/j.issn.2095-6959.2022.02.009
Abstract
Objective: To investigate the effect of butylphthalide sequential therapy on neurological deficit, and serum homocysteine (Hcy), and low-density lipoprotein cholesterol (LDL-C) in patients with ischemic stroke. Methods: The data of 120 patients with ischemic stroke admitted to Chizhou People’s Hospital from January 2020 to March 2021 were retrospectively analyzed. According to different treatment methods, they were divided into a control group (64 cases) and a study group (56 cases). The control group was given conventional standard treatment, and the study group was given additional butylphthalide sequential therapy. The results of brain Doppler examination, NIH Stroke Scale (NIHSS) score reduction rate, serum indexes (Hcy, LDL-C), and short-term prognosis of the two groups were compared. Results: The opening rate of cerebral artery collateral circulation in the study group was higher than that in the control group at 7 and 14 days after treatment, and the NIHSS score reduction rate at 14 and 90 days after treatment was higher than that in the control group. After 14 days of treatment, serum levels of Hcy [(15.18±3.89) μmol/L] and LDL-C [(2.93±0.37) mmol/L] were lower than those of the control group [(18.24±4.16) μmol/L and (3.10±0.44) mmol/L]. The above differences were statistically significant (all P<0.05). After 14 days of treatment, serum Hcy and LDL-C levels were negatively correlated with NIHSS score reduction rate (r=−0.725 and −0.690, respectively, P<0.05). After 90 days of treatment, the good prognosis rate of the study group was 58.93%, which was higher than that of the control group (39.06%), and the difference was statistically significant (P<0.05). Sequential butylphthalide therapy was a protective factor for the good prognosis of patients with ischemic stroke after 90 days of treatment [odds ratio (OR) =1.372, 95%CI: 1.103 to 1.579, P<0.05]. Conclusion: Butylphthalide sequential therapy can promote the opening of cerebral artery collateral circulation, reduce the levels of serum Hcy and LDL-C, and alleviate the neurological deficit in patients with ischemic stroke, and it is a protective factor for good short-term prognosis.
Keywords：
ischemic stroke; butylphthalide; sequential therapy; nerve function; homocysteine; low-density lipoprotein cholesterol