天津医药

天津医药 ›› 2022, Vol. 50 ›› Issue (5): 544-547.doi: 10.11958/20212398

• 药物临床观察 • 上一篇    下一篇

丁苯酞下调血清脂蛋白相关磷脂酶A2改善急性大动脉#br# 粥样硬化型脑梗死患者预后的临床观察#br#

林玉凤，汪志云，王雪松△   

  1. 天津市第一中心医院神经内科（邮编300192）
  • 收稿日期:2021-10-23 修回日期:2021-12-27 出版日期:2022-05-15 发布日期:2022-07-04

The clinical observation of butylphthalide improves the prognosis of patients with acute large-artery atherosclerosis cerebral infarction by decreasing serum #br# lipoprotein-related phospholipase A2#br#

LIN Yufeng, WANG Zhiyun, WANG Xuesong△   

  1. Department of Neurology, Tianjin First Central Hospital, Tianjin 300192, China
  • Received:2021-10-23 Revised:2021-12-27 Published:2022-05-15 Online:2022-07-04

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摘要： 目的　探讨丁苯酞能否通过调节急性大动脉粥样硬化型（LAA）脑梗死患者血清脂蛋白相关磷脂酶A2（Lp-PLA2）、颈动脉内膜中层厚度（IMT）而改善患者预后。方法　选择急性LAA脑梗死患者60例，随机分为丁苯酞组及对照组，每组30例。丁苯酞组予静脉滴注丁苯酞注射液（100 mL/次，2次/日，连续14 d），序贯口服丁苯酞软胶囊（0.2 g/次，3次/日，连续11.5个月），对照组静脉滴注生理盐水（100 mL/次，2次/日，连续14 d）。所有患者均于治疗前及治疗12个月后检测血清Lp-PLA2水平；行颈部血管超声检测IMT并采用美国国立卫生研究院卒中量表（NIHSS）评估患者神经功能缺损情况。结果　2组患者治疗后的Lp-PLA2水平比治疗前均有所下降，但丁苯酞组Lp-PLA2水平下降较对照组更为明显（P＜0.01）。治疗12个月后，丁苯酞组患者IMT值低于对照组（P＜0.05）。2组患者治疗后NIHSS评分均明显下降，但丁苯酞组下降更为显著（P＜0.01）。结论　丁苯酞治疗可以降低血清Lp-PLA2水平，进而缓解动脉粥样硬化进展，改善急性LAA脑梗死患者的预后。

关键词: 脑梗死, 磷脂酶类A2, 1-烷基-2-乙酰甘油磷酸胆碱酯酶, 动脉粥样硬化, 预后, 丁苯酞

Abstract: Objective　To explore whether butylphthalide can improve the prognosis of patients with acute large-artery atherosclerosis (LAA) cerebral infarction by regulating serum level of lipoprotein-related phospholipase A2 (Lp-PLA2) and carotid intima-media thickness (IMT). Methods　Sixty patients with acute LAA cerebral infarction were recruited and randomly divided into the two groups: the butylphthalide group and the control group, with 30 cases in each group. The butylphthalide group was intravenously injected with butylphthalide injection (100 mL/dose, 2 times/day for 14 days) and received sequential oral butylphthalide soft capsule (0.2 g/dose, 3 times/day for 11.5 months), while the control group was given intravenous drip of normal saline (100 mL/dose, 2 times/day for 14 days). Serum levels of Lp-PLA2, IMT from cervical vascular ultrasound examination and neurological deficit score (NIHSS score) were measured before treatment and 12 months after treatment. Results　The level of Lp-PLA2 in both groups decreased after treatment compared with before treatment (P＜0.05), but the decrease was more obvious in the butylphthalide group than that in the control group (P＜0.01). After 12 months of treatment, IMT was significantly lower in the butylphthalide group than that in the control group (P＜0.05). NIHSS scores were significantly decreased after treatment in the two groups (P＜0.05), but the decrease in the butylphthalide group was more significant (P＜0.01). Conclusion　Butylphthalide treatment can reduce the serum Lp-PLA2 level and alleviate the progression of atherosclerosis so that improve the prognosis of patients with acute LAA cerebral infarction.

Key words: brain infarction, phospholipases A2, 1-alkyl-2-acetylglycerophosphocholine esterase, atherosclerosis, prognosis, butylphthalide

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