丁苯酞對(duì)急性腦梗死患者血清白介素-6的影響
發(fā)布時(shí)間：2019-02-28 21:33
【摘要】：背景和目的： 急性腦梗死的溶栓治療已得到臨床的廣泛認(rèn)同,但多數(shù)患者來(lái)院就診時(shí)已錯(cuò)過(guò)溶栓治療時(shí)機(jī),因此探索從其他病理環(huán)節(jié)進(jìn)行干預(yù)治療在急性腦梗死仍有必要。現(xiàn)有的研究表明丁苯酞可增加缺血區(qū)腦血流量和改善腦缺血區(qū)微循環(huán),保護(hù)線粒體功能,改善全腦缺血后腦的能量代謝,抑制鈣內(nèi)流等,涉及腦缺血病理的多個(gè)環(huán)節(jié),對(duì)急性腦梗死具有一定的治療保護(hù)作用。本研究主要通過(guò)觀察丁苯酞對(duì)急性腦梗死患者白介素6(IL-6)、超敏CRP、血小板聚集率的影響,并探討神經(jīng)功能缺損與IL-6等的相關(guān)性。 方法： 連續(xù)選擇發(fā)病48小時(shí)以內(nèi)的頸內(nèi)動(dòng)脈系統(tǒng)腦梗死的患者80例,隨機(jī)分為治療組和對(duì)照組,20名健康體檢者作為正常對(duì)照組,治療組和對(duì)照組均采用常規(guī)治療,包括抗血小板聚集、他汀類等藥物,治療組在常規(guī)治療基礎(chǔ)上加用丁苯肽膠囊200mg口服,3次/d。在治療前和治療后30天對(duì)治療組和對(duì)照組腦梗死患者進(jìn)行美國(guó)國(guó)立衛(wèi)生院卒中量表(NIHSS)評(píng)分,治療后3個(gè)月進(jìn)行改良Rankin評(píng)分(mRS)以觀察神經(jīng)功能恢復(fù)情況。在治療前和治療第7天分別檢測(cè)治療組和對(duì)照組患者的超敏CRP、IL-6、血小板聚集率,同時(shí)對(duì)神經(jīng)功能缺損評(píng)分與超敏CRP、IL-6、血小板聚集率的相關(guān)性進(jìn)行分析。 結(jié)果： 1.治療前治療組和對(duì)照組的超敏CRP、IL-6、血小板聚集率水平均高于正常對(duì)照組,兩組間比較有統(tǒng)計(jì)學(xué)差異(P0.05),治療第7天后兩組超敏CRP、IL-6、血小板聚集率水平均較治療前下降,且治療組的超敏CRP、IL-6、血小板聚集率水平較對(duì)照組下降更加明顯,差異有顯著統(tǒng)計(jì)學(xué)意義(P0.05)。 2.治療前治療組和對(duì)照組神經(jīng)功能損傷程度評(píng)分無(wú)明顯差異；治療后兩組的評(píng)分均較治療前明顯下降,但與對(duì)照組相比,治療組治療后的評(píng)分較前下降更為顯著(P0.05)。 3.急性腦梗死患者NIHSS評(píng)分、mRS評(píng)分與超敏CRP、IL-6及血小板聚集率呈正相關(guān)(P0.05)。 結(jié)論： 丁苯酞能夠明顯改善急性腦梗死患者神經(jīng)功能缺損的癥狀,并降低急性腦梗死患者超敏CRP、IL-6、血小板聚集率的水平,且神經(jīng)功能的改善與超敏CRP、IL-6水平及血小板聚集率的下降呈正相關(guān),提示丁苯酞在急性腦梗死患者中能降低IL-6水平、減輕炎癥反應(yīng)和抑制血小板聚集,并促進(jìn)神經(jīng)功能的恢復(fù)。
[Abstract]:Background and objective: thrombolytic therapy for acute cerebral infarction has been widely recognized in clinical practice, but most patients have missed the opportunity of thrombolytic therapy when they come to hospital. Therefore, it is still necessary to explore the intervention from other pathological links in acute cerebral infarction. Current studies have shown that butylphthalide can increase cerebral blood flow and improve microcirculation in ischemic area, protect mitochondrial function, improve energy metabolism after global cerebral ischemia, inhibit calcium influx, and so on, which involve many links of cerebral ischemia pathology. It has certain therapeutic and protective effects on acute cerebral infarction. The purpose of this study was to investigate the effect of buphthalide on the platelet aggregation rate of interleukin-6 (IL-6) and hypersensitive CRP, in patients with acute cerebral infarction (ACI), and to explore the relationship between neurologic deficit and IL-6. Methods: 80 patients with cerebral infarction of internal carotid artery system within 48 hours of onset were randomly divided into treatment group and control group, and 20 healthy persons were taken as normal control group. The treatment group and control group were treated with routine therapy, and the patients with cerebral infarction were divided into two groups: treatment group and control group. Including antiplatelet aggregation, statins and other drugs, the treatment group was treated with bubene peptide capsule 200mg oral on the basis of routine treatment, 3 times / d. The patients with cerebral infarction in the treatment group and control group were assessed with (NIHSS) before treatment and 30 days after treatment. Three months after treatment, the patients with cerebral infarction were treated with modified Rankin score (mRS) to observe the recovery of neurologic function. The platelet aggregation rate of hypersensitive CRP,IL-6, in treatment group and control group was measured before and 7 days after treatment, and the correlation between neural function defect score and hypersensitive CRP,IL-6, platelet aggregation rate was analyzed. Results: 1. The platelet aggregation rate of hypersensitive CRP,IL-6, in the treatment group and the control group was higher than that in the normal control group before treatment (P0.05). After 7 days of treatment, the platelet aggregation rate of hypersensitive CRP,IL-6, in the two groups was significantly higher than that in the control group (P0.05). The platelet aggregation rate of the treatment group was significantly lower than that of the control group, and the platelet aggregation rate of the treatment group was significantly lower than that of the control group (P0.05). The platelet aggregation rate of the treatment group was significantly lower than that of the control group. 2. There was no significant difference between the treatment group and the control group before the treatment; the scores of the two groups after treatment were significantly lower than those before treatment, but the scores of the treatment group after treatment were more significantly lower than that of the control group (P0.05). 3. NIHSS score and mRS score were positively correlated with hypersensitivity CRP,IL-6 and platelet aggregation rate in patients with acute cerebral infarction (P0.05). Conclusion: butylphthalide can significantly improve the symptoms of neurological deficit in patients with acute cerebral infarction and decrease the platelet aggregation rate of hypersensitive CRP,IL-6, in patients with acute cerebral infarction, and the improvement of neural function and hypersensitive CRP,. There was a positive correlation between the level of IL-6 and the decrease of platelet aggregation rate, which suggested that butylphthalide could decrease the level of IL-6, reduce the inflammatory reaction, inhibit platelet aggregation and promote the recovery of nerve function in patients with acute cerebral infarction.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R743.3
本文編號(hào)：2432190
[Abstract]:Background and objective: thrombolytic therapy for acute cerebral infarction has been widely recognized in clinical practice, but most patients have missed the opportunity of thrombolytic therapy when they come to hospital. Therefore, it is still necessary to explore the intervention from other pathological links in acute cerebral infarction. Current studies have shown that butylphthalide can increase cerebral blood flow and improve microcirculation in ischemic area, protect mitochondrial function, improve energy metabolism after global cerebral ischemia, inhibit calcium influx, and so on, which involve many links of cerebral ischemia pathology. It has certain therapeutic and protective effects on acute cerebral infarction. The purpose of this study was to investigate the effect of buphthalide on the platelet aggregation rate of interleukin-6 (IL-6) and hypersensitive CRP, in patients with acute cerebral infarction (ACI), and to explore the relationship between neurologic deficit and IL-6. Methods: 80 patients with cerebral infarction of internal carotid artery system within 48 hours of onset were randomly divided into treatment group and control group, and 20 healthy persons were taken as normal control group. The treatment group and control group were treated with routine therapy, and the patients with cerebral infarction were divided into two groups: treatment group and control group. Including antiplatelet aggregation, statins and other drugs, the treatment group was treated with bubene peptide capsule 200mg oral on the basis of routine treatment, 3 times / d. The patients with cerebral infarction in the treatment group and control group were assessed with (NIHSS) before treatment and 30 days after treatment. Three months after treatment, the patients with cerebral infarction were treated with modified Rankin score (mRS) to observe the recovery of neurologic function. The platelet aggregation rate of hypersensitive CRP,IL-6, in treatment group and control group was measured before and 7 days after treatment, and the correlation between neural function defect score and hypersensitive CRP,IL-6, platelet aggregation rate was analyzed. Results: 1. The platelet aggregation rate of hypersensitive CRP,IL-6, in the treatment group and the control group was higher than that in the normal control group before treatment (P0.05). After 7 days of treatment, the platelet aggregation rate of hypersensitive CRP,IL-6, in the two groups was significantly higher than that in the control group (P0.05). The platelet aggregation rate of the treatment group was significantly lower than that of the control group, and the platelet aggregation rate of the treatment group was significantly lower than that of the control group (P0.05). The platelet aggregation rate of the treatment group was significantly lower than that of the control group. 2. There was no significant difference between the treatment group and the control group before the treatment; the scores of the two groups after treatment were significantly lower than those before treatment, but the scores of the treatment group after treatment were more significantly lower than that of the control group (P0.05). 3. NIHSS score and mRS score were positively correlated with hypersensitivity CRP,IL-6 and platelet aggregation rate in patients with acute cerebral infarction (P0.05). Conclusion: butylphthalide can significantly improve the symptoms of neurological deficit in patients with acute cerebral infarction and decrease the platelet aggregation rate of hypersensitive CRP,IL-6, in patients with acute cerebral infarction, and the improvement of neural function and hypersensitive CRP,. There was a positive correlation between the level of IL-6 and the decrease of platelet aggregation rate, which suggested that butylphthalide could decrease the level of IL-6, reduce the inflammatory reaction, inhibit platelet aggregation and promote the recovery of nerve function in patients with acute cerebral infarction.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R743.3
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