摘要
目的观察局部亚低温联合丁苯酞注射液治疗对急性脑梗死(ACI)患者细胞凋亡、斑块稳定性的影响。方法收集2016年2月—2018年12月沈阳市红十字会医院神经内科治疗ACI患者104例的临床资料,采用随机数字表法分为2组,各52例。对照组予阿托伐他汀钙、拜阿司匹林等常规对症治疗,观察组在对照组基础上给予局部亚低温联合丁苯酞注射液治疗,均连续治疗14 d。比较2组临床疗效、生活质量及神经功能、颈动脉内膜中层厚度(IMT)、颈动脉斑块面积、斑块稳定性指标、细胞凋亡相关分子、不良反应发生情况。结果观察组临床疗效高于对照组(92.30%vs.76.92%,χ^2=4.704,P=0.033)。治疗后14 d,观察组NHISS评分明显低于对照组,ADL评分则明显高于对照组(t/P=3.784/0.000、5.347/0.000);IMT、颈动脉斑块面积明显低于对照组(t/P=8.004/0.000、8.579/0.000);斑块稳定性指标MMP-2、Lox-1、Cat K及凋亡相关分子sFas、sFasL均明显低于对照组,Bcl-2高于对照组(t/P=13.734/0.000、6.594/0.000、9.364/0.000、8.934/0.000、7.204/0.000,5.694/0.000);2组不良反应发生率比较差异无统计学意义(P>0.05)。结论局部亚低温联合丁苯酞注射液治疗ACI疗效确切,可有效稳定动脉粥样硬化斑块,抑制神经细胞凋亡,改善患者神经功能恢复及预后质量。
Objective To observe the effect of local mild hypothermia combined with butylphthalide injection on apoptosis and plaque stability in patients with acute cerebral infarction(ACI).Methods From February 2016 to December 2018,clinical data of 104 patients with ACI treated in Neurology Department of Shenyang Red Cross Hospital were collected.Randomly divided into two groups,52 cases in each group.The control group was treated with atorvastatin calcium and aspirin.The observation group was treated with local mild hypothermia and butylphthalide injection on the basis of the control group for 14 days.The clinical effect,quality of life and nerve function,carotid intima-media thickness(IMT),carotid plaque area,plaque stability index,apoptosis related molecules and adverse reactions were compared between the two groups.Results The clinical efficacy of the observation group was higher than that of the control group(92.30%vs.76.92%,χ^2=4.704,P=0.033).At 14 days after treatment,the NHISS score of the observation group was significantly lower than that of the control group,and the ADL score was significantly higher than that of the control group(t/P=3.784/0.000,5.347/0.000).The area of IMT and carotid plaque was significantly lower than that of the control group(t/P=8.004/0.000,8.579/0.000);plaque stability indicators MMP-2,Lox-1,Cat K and apoptosis-related molecules sFas,sFasL were significantly lower than the control group,Bcl-2 was higher than the control group(t/P=13.734/0.000,6.594/0.000,9.364/0.000,8.934/0.000,7.204/0.000,5.694/0.000);there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Local mild hypothermia combined with butylphthalide injection is effective in the treatment of ACI.It can effectively stabilize atherosclerotic plaque,inhibit the apoptosis of nerve cells,and improve the recovery of neurological function and the quality of prognosis.
作者
邹蔷薇
王惠婕
何欣
陈敏
ZOU Qiangiwei;WANG Huijie;HE Xin;CHEN Min(Department of Neurology,Shenyang Red Cross Hospital,Liaoning Province,Shenyang 110023,China)
出处
《疑难病杂志》
CAS
2019年第11期1099-1102,1107,共5页
Chinese Journal of Difficult and Complicated Cases
基金
辽宁省科学技术计划项目(2014021100)
关键词
局部亚低温
丁苯酞注射液
脑梗死
急性
细胞凋亡
斑块稳定性
Local mild hypothermia
Butylphthalide injection
Cerebral infarction
acute
Apoptosis
Plaque stability
