丁苯酞联合依达拉奉治疗脑梗死急性期老年患者的疗效分析

Therapeutic efficacy of butylphthalide combined with edaravone in elderly patients with acute cerebral infarction

摘要:

目的 探讨丁苯酞联合依达拉奉对脑梗死急性期老年患者脑血流动力学、血管斑块稳定性及血清同型半胱氨酸（Hcy）、超敏C反应蛋白（hs-CRP）水平的影响。方法 选取2018年5月—2019年12月永康市第一人民医院收治的脑梗死急性期老年患者82例，采用随机数字表法将患者分为观察组和对照组，每组41例。观察组给予丁苯酞联合依达拉奉治疗；对照组给予依达拉奉治疗，均治疗2周。比较两组治疗2周总有效率；治疗前与治疗2周日常生活能力（ADL）评分和美国国立研究院卒中量表（NIHSS）评分、脑血流动力学、血管斑块稳定性、Hcy和hs-CRP水平的变化。结果 观察组总有效率高于对照组（P <0.05）。观察组治疗前后ADL评分和NIHSS评分的差值大于对照组（P <0.05）。观察组治疗前后峰流速、平均流速的差值大于对照组（P <0.05）。两组治疗后稳定斑块比例高于治疗前（P <0.05）。治疗前，两组稳定斑块比例比较，差异无统计学意义（P >0.05）；治疗2周后，观察组稳定斑块比例高于对照组（P <0.05）。观察组治疗前后血清Hcy、hs-CRP的差值大于对照组（P <0.05）。结论 丁苯酞联合依达拉奉治疗脑梗死急性期老年患者疗效良好，且可改善患者脑血流动力学和血管斑块稳定性，降低血清Hcy、hs-CRP水平。

Abstract:

Objective To investigate the effects of butylphthalide combined with edaravone on cerebral hemodynamics, vascular plaque stability and serum levels of homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) in elderly patients with acute cerebral infarction.Methods The 82 elderly patients with acute cerebral infarction admitted to Yongkang First People's Hospital from May 2018 to December 2019 were randomly divided into observation group (41 cases) and control group (41 cases). The observation group was treated with butylphthalide combined with edaravone, while the control group was treated with edaravone alone. The treatment course of the two groups was 2 weeks. The overall effective rate was compared between the two groups after 2 weeks of treatment. The changes of Activities of Daily Living (ADL) and National Institutes of Health Stroke Scale (NIHSS) scores, cerebral hemodynamics, vascular plaque stability, and serum Hcy and hs-CRP levels before and after 2 weeks of treatment were compared.Results The overall effective rate of the observation group was higher than that of the control group (P < 0.05). The differences of ADL score and NIHSS score before and after treatment in the observation group were higher than those in the control group (P < 0.05). The differences of peak velocity (V_P) and mean velocity (V_M) in cerebral hemodynamics before and after treatment were also higher in the observation group (P <0.05). The proportion of stable plaque increased in both groups after treatment (P < 0.05). There was no difference in the proportion of stable plaque between the two groups before the treatment (P > 0.05), whereas the proportion of stable plaque was higher in the observation group compared with the control group after two weeks of treatment (P < 0.05). The differences of serum Hcy and hs-CRP levels before and after treatment were greater in the observation group than those in the control group (P < 0.05).Conclusions Butylphthalide combined with edaravone shows great therapeutic efficacy in elderly patients with acute cerebral infarction. It can improve cerebral hemodynamics and vascular plaque stability, and reduce the serum Hcy and hs-CRP levels.