摘要
目的探讨丁苯酞联合阿加曲班、氯吡格雷治疗对进展性脑梗死患者神经功能、日常生活能力、炎性因子水平及脑血流动力学指标的影响。方法按照随机数字表法将2020年1月至2021年2月苏州市第九人民医院收治的90例进展性脑梗死患者,分为对照组和观察组,各45例。给予对照组患者阿加曲班与氯吡格雷治疗,观察组患者在对照组的基础上联合丁苯酞治疗,两组患者均连续治疗2周。比较两组患者临床治疗效果,治疗前后日常生活能力、神经功能、炎性因子、脑血流动力学指标、血浆D-二聚体(D-D)、纤维蛋白原(FIB)及血小板计数(PLT)水平。结果治疗后观察组患者临床总有效率为84.44%,高于对照组的60.00%;治疗后两组患者美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分,血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏-C反应蛋白(hs-CRP)、血浆D-D、FIB水平较治疗前均降低,且观察组低于对照组;两组患者Barthel指数(BI)、PLT水平均升高,且观察组高于对照组;大脑中动脉平均流速、收缩期峰值流速均升高,且观察组高于对照组;治疗后两组患者峰值流速差、平均流速差均有所降低,且观察组低于对照组(均P <0.05)。结论丁苯酞联合阿加曲班、氯吡格雷治疗进展性脑梗死患者,可有效提高临床疗效,缓解患者机体炎性反应,纠正脑血流动力学异常,加快神经功能的恢复,改善日常生活能力,治疗效果显著。
Objective To explore the effects of Butylphthalide combined with Argatroban and Clopidogrel on the neurological function,ability of daily living,inflammatory factor levels and cerebral hemodynamics indexes levels of patients with progressive cerebral infarction.Methods 90 cases patients with progressive cerebral infarction admitted to Suzhou Ninth People’s Hospital from January 2020 to February 2021 were divided into the control group and the observation group according to the random number table method,each group with 45 cases.Patients in the control group were treated with Argatroban and Clopidogrel,patients in the observation group were treated with Butylphthalide on the basis of the control group,patients in the both groups were treated continuously for 2 weeks.The clinical treatment effect,activity of daily living,nerve function,inflammatory factors,cerebral hemodynamic indicators,plasma D-dimer(D-D),fibrinogen(FIB) and platelet count(PLT) levels of patients before and after treatment in the two groups were compared.Results After treatment,the total clinical effective rate of patients in the observation group was 84.44%,which was higher than 60.00% in the control group;compared with before treatment,the National Institutes of Health Stroke Scale(NIHSS) score,modified Rankin scale(mRS) score,serum interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP) levels,and the plasma D-D,and FIB levels of patients in the two groups after treatment decreased,and the observation group was lower than the control group;the Barthel Index(BI) and PLT levels of patients in the two groups after treatment increased,and the observation group was higher than the control group;the average flow velocity of the middle cerebral artery and the peak systolic flow velocity of patients in the two groups after treatment increased,and the observation group was higher than the control group;the difference of peak flow rate and the difference of average flow rate of patients in the two groups after treatment reduced,and the observation group was lower than the control group(all P < 0.05).Conclusion Butylphthalide combined with Argatroban and Clopidogrel in the treatment of patients with progressive cerebral infarction can effectively improve the clinical efficacy,relieve the patients’ inflammatory response,correct abnormal cerebral hemodynamics,accelerate the recovery of nerve function,and improve the ability of daily living,the treatment effect is remarkable.
作者
王静雯
WANG Jingwen(Department of Neurology,Suzhou Ninth People's Hospital,Suzhou,Jiangsu 215200,China)
关键词
进展性脑梗死
阿加曲班
氯吡格雷
丁苯酞
神经功能
炎性因子
脑血流动力学
Progressive cerebral infarction
Agatroban
Clopidogrel
Butylphthalide
Nerve function
Inflammatory factors
Cerebral hemodynamics
