丁苯酞对急性脑梗死患者血清白介素-6的影响
发布时间：2019-02-28 21:33
【摘要】：背景和目的： 急性脑梗死的溶栓治疗已得到临床的广泛认同,但多数患者来院就诊时已错过溶栓治疗时机,因此探索从其他病理环节进行干预治疗在急性脑梗死仍有必要。现有的研究表明丁苯酞可增加缺血区脑血流量和改善脑缺血区微循环,保护线粒体功能,改善全脑缺血后脑的能量代谢,抑制钙内流等,涉及脑缺血病理的多个环节,对急性脑梗死具有一定的治疗保护作用。本研究主要通过观察丁苯酞对急性脑梗死患者白介素6(IL-6)、超敏CRP、血小板聚集率的影响,并探讨神经功能缺损与IL-6等的相关性。 方法： 连续选择发病48小时以内的颈内动脉系统脑梗死的患者80例,随机分为治疗组和对照组,20名健康体检者作为正常对照组,治疗组和对照组均采用常规治疗,包括抗血小板聚集、他汀类等药物,治疗组在常规治疗基础上加用丁苯肽胶囊200mg口服,3次/d。在治疗前和治疗后30天对治疗组和对照组脑梗死患者进行美国国立卫生院卒中量表(NIHSS)评分,治疗后3个月进行改良Rankin评分(mRS)以观察神经功能恢复情况。在治疗前和治疗第7天分别检测治疗组和对照组患者的超敏CRP、IL-6、血小板聚集率,同时对神经功能缺损评分与超敏CRP、IL-6、血小板聚集率的相关性进行分析。 结果： 1.治疗前治疗组和对照组的超敏CRP、IL-6、血小板聚集率水平均高于正常对照组,两组间比较有统计学差异(P0.05),治疗第7天后两组超敏CRP、IL-6、血小板聚集率水平均较治疗前下降,且治疗组的超敏CRP、IL-6、血小板聚集率水平较对照组下降更加明显,差异有显著统计学意义(P0.05)。 2.治疗前治疗组和对照组神经功能损伤程度评分无明显差异；治疗后两组的评分均较治疗前明显下降,但与对照组相比,治疗组治疗后的评分较前下降更为显著(P0.05)。 3.急性脑梗死患者NIHSS评分、mRS评分与超敏CRP、IL-6及血小板聚集率呈正相关(P0.05)。 结论： 丁苯酞能够明显改善急性脑梗死患者神经功能缺损的症状,并降低急性脑梗死患者超敏CRP、IL-6、血小板聚集率的水平,且神经功能的改善与超敏CRP、IL-6水平及血小板聚集率的下降呈正相关,提示丁苯酞在急性脑梗死患者中能降低IL-6水平、减轻炎症反应和抑制血小板聚集,并促进神经功能的恢复。
[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.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R743.3
本文编号：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.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R743.3
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