丁苯酞联合脑苷肌肽治疗急性脑梗死患者的效果及对血清肿瘤坏死因子、白细胞介素6和血管内皮生长因子的影响
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摘要
目的探讨丁苯酞联合脑苷肌肽对急性脑梗死患者的效果,及对血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6和血管内皮生长因子(VEGF)水平的影响。方法将90例急性脑梗死患者按随机数字表法分为对照组45例(给予丁苯酞治疗),观察组45例(给予丁苯酞联合脑苷肌肽治疗),共14 d。两组基础用药相同。比较两组患者治疗前、后神经功能缺损程度(NIHSS)及日常生活活动量(ADL)评分,检测两组治疗前后血清TNF-α、IL-6和VEGF水平。结果观察组疗效显著优于对照组,差异有统计学意义(P <0. 05)。治疗后,两组NIHSS评分均低于治疗前,且观察组低于对照组,差异均有统计学意义(均P <0. 05)。治疗后,两组ADL评分高于治疗前,且观察组高于对照组,差异均有统计学意义(均P <0. 05)。治疗后,观察组血清TNF-α、IL-6水平显著低于对照组,VEGF水平显著高于对照组,差异有统计学意义(P <0. 05)。结论丁苯酞联合脑苷肌肽能更好地改善急性脑梗死患者的神经功能,提高日常生活能力;显著降低血清TNF-α、IL-6水平,提高VEGF水平。
Objective To explore the effect of butylphthalide combined with cattle encephalon glycoside and ignotin on the levels of serum TNF-α,IL-6 and VEGF and the therapeutic effect in acute cerebral infarction patients( ACI). Methods 90 cases with ACI were randomly divided into two groups. 45 cases in the control group were treated with butylphthalide therapy. 45 cases in the observation group were treated with butylphthalide combined with cattle encephalon glycoside and ignotin therapy for 14 days. The conventional treatments in two groups were same. The neurological impairment score( NIHSS) and activity of daily living( ADL) scale were evaluated and compared before and after treatment between the two groups. Enzyme linked immunosorbent assay( ELISA) was used to detect and compare the levels of TNF-α,IL-6,VEGF at the admission day,14 th day after admission. Results The effective rate in observation group was significantly higher than that in control group( P < 0. 05). NIHSS neurological deficit score after treatment in two groups was significantly lower than that in pre-treatment,and it in observation group was significantly lower than that in control group( P < 0. 05). Activity of daily living( ADL) score after treatment in two groups were significantly higher than those in pre-treatment,and they in observation group were significantly higher than those in control group( P <0. 05). After treatment,serum TNF-α,IL-6 levels in observation group was significantly lower than those in control group,and serum VEGF level in observation group were significantly higher than that in control group( P < 0. 05). Conclusion Butylphthalide combined with cattle encephalon glycoside and ignotin can promote the improvement of activities of daily living and recovery of neurological function and decrease the serum levels of TNF-α and IL-6 and raise the level of VEGF.
Objective To explore the effect of butylphthalide combined with cattle encephalon glycoside and ignotin on the levels of serum TNF-α,IL-6 and VEGF and the therapeutic effect in acute cerebral infarction patients( ACI). Methods 90 cases with ACI were randomly divided into two groups. 45 cases in the control group were treated with butylphthalide therapy. 45 cases in the observation group were treated with butylphthalide combined with cattle encephalon glycoside and ignotin therapy for 14 days. The conventional treatments in two groups were same. The neurological impairment score( NIHSS) and activity of daily living( ADL) scale were evaluated and compared before and after treatment between the two groups. Enzyme linked immunosorbent assay( ELISA) was used to detect and compare the levels of TNF-α,IL-6,VEGF at the admission day,14 th day after admission. Results The effective rate in observation group was significantly higher than that in control group( P < 0. 05). NIHSS neurological deficit score after treatment in two groups was significantly lower than that in pre-treatment,and it in observation group was significantly lower than that in control group( P < 0. 05). Activity of daily living( ADL) score after treatment in two groups were significantly higher than those in pre-treatment,and they in observation group were significantly higher than those in control group( P <0. 05). After treatment,serum TNF-α,IL-6 levels in observation group was significantly lower than those in control group,and serum VEGF level in observation group were significantly higher than that in control group( P < 0. 05). Conclusion Butylphthalide combined with cattle encephalon glycoside and ignotin can promote the improvement of activities of daily living and recovery of neurological function and decrease the serum levels of TNF-α and IL-6 and raise the level of VEGF.
引文
[1]陈娜,陆连生,李虹,等.丁苯酞序贯治疗急性脑梗死合并认知功能障碍患者的疗效及其对炎性因子的影响[J].疑难病杂志,2017,16(2):117-121.
[2]张良明,王菲,柏若玉.脑苷肌肽对缺血性脑卒中患者的疗效及血清细胞因子水平的影响[J].卒中与神经疾病,2017,24(3):241-242.
[3] KASNER S E. Clinical interpretation and use of strokescales[J]. Lancet Neurol,2006,5(7):603-612.
[4]陈清棠.脑卒中患者临床神经功能缺损程度评分标准(全国第四届脑血管病学术会议通过)[J].中华神经科杂志,1996,29(6):381-383.
[5]王晋芳.丁苯酞注射液联合脑苷肌肽治疗老年急性脑梗死48例临床疗效观察[J].临床医药实践,2017,26(3):237-238.
[6]张文华.丁苯酞注射液联合温胆汤治疗急性脑梗死的疗效及对血清炎性因子的影响[J].中国实用神经疾病杂志,2015,18(21):62-65.
[7]李国山.不同剂量丁苯酞对急性脑梗死患者血管内皮功能及肝肾功能的影响[J].临床合理用药杂志,2016,9(15):1-2.
[8]张轶美,刘霄,韩毅,等.丁苯酞联合血塞通对急性脑梗死患者认知功能及血清TNF-α、IL-10和NSE的影响[J].现代中西医结合杂志,2018,27(5):541-544.
[9]朱英,王建军,叶建新.丁苯酞治疗超高龄老人后循环缺血疗效观察[J].中国临床保健杂志,2014,17(2):171-172.
[10]刘信东,王欣,曹秋菊,等.丁苯酞对急性脑梗死患者侧支循环的影响[J].西南国防医药,2018,28(2):117-120.
[11]李婛,季兴,谭庆晶.丁苯酞联合疏血通治疗急性脑梗死的疗效观察[J].中国临床保健杂志,2012,15(6):648-649.
[12]沈流燕,周莉.脑苷肌肽注射液联合参附注射液对老年急性脑梗死患者神经功能恢复的影响[J].中国实用神经疾病杂志,2016,19(22):7-8.
[13]蔡秀颜,杨职,袁莉,等.脑苷肌肽辅助治疗脑梗死老年患者的临床价值分析[J].深圳中西医结合杂志,2015,25(13):64-65.
[14]李玲玲,肖锦荣,喻萍,等.脑苷肌肽治疗急性缺血性脑梗死的临床观察[J].中国临床保健杂志,2015,18(3):297-298.
[2]张良明,王菲,柏若玉.脑苷肌肽对缺血性脑卒中患者的疗效及血清细胞因子水平的影响[J].卒中与神经疾病,2017,24(3):241-242.
[3] KASNER S E. Clinical interpretation and use of strokescales[J]. Lancet Neurol,2006,5(7):603-612.
[4]陈清棠.脑卒中患者临床神经功能缺损程度评分标准(全国第四届脑血管病学术会议通过)[J].中华神经科杂志,1996,29(6):381-383.
[5]王晋芳.丁苯酞注射液联合脑苷肌肽治疗老年急性脑梗死48例临床疗效观察[J].临床医药实践,2017,26(3):237-238.
[6]张文华.丁苯酞注射液联合温胆汤治疗急性脑梗死的疗效及对血清炎性因子的影响[J].中国实用神经疾病杂志,2015,18(21):62-65.
[7]李国山.不同剂量丁苯酞对急性脑梗死患者血管内皮功能及肝肾功能的影响[J].临床合理用药杂志,2016,9(15):1-2.
[8]张轶美,刘霄,韩毅,等.丁苯酞联合血塞通对急性脑梗死患者认知功能及血清TNF-α、IL-10和NSE的影响[J].现代中西医结合杂志,2018,27(5):541-544.
[9]朱英,王建军,叶建新.丁苯酞治疗超高龄老人后循环缺血疗效观察[J].中国临床保健杂志,2014,17(2):171-172.
[10]刘信东,王欣,曹秋菊,等.丁苯酞对急性脑梗死患者侧支循环的影响[J].西南国防医药,2018,28(2):117-120.
[11]李婛,季兴,谭庆晶.丁苯酞联合疏血通治疗急性脑梗死的疗效观察[J].中国临床保健杂志,2012,15(6):648-649.
[12]沈流燕,周莉.脑苷肌肽注射液联合参附注射液对老年急性脑梗死患者神经功能恢复的影响[J].中国实用神经疾病杂志,2016,19(22):7-8.
[13]蔡秀颜,杨职,袁莉,等.脑苷肌肽辅助治疗脑梗死老年患者的临床价值分析[J].深圳中西医结合杂志,2015,25(13):64-65.
[14]李玲玲,肖锦荣,喻萍,等.脑苷肌肽治疗急性缺血性脑梗死的临床观察[J].中国临床保健杂志,2015,18(3):297-298.