丁基苯酞治疗急性脑梗死的疗效及对神经功能和生活质量的影响

摘要

目的:评估丁基苯酞注射液治疗急性脑梗死的疗效以及对患者神经功能和生活质量的影响.方法:选择本院收治的106例急性脑梗死患者作为观察对象,随机均分为常规治疗组与丁基苯酞组(在常规治疗基础上给予丁基苯酞注射液治疗) ,治疗14d后,评估两组临床疗效,比较治疗前、后两组患者神经功能指标;随访3个月,比较两组患者治疗前、随访时的认知功能、生活质量变化情况.结果:丁基苯酞组总有效率显著高于常规治疗组(88.68% 比67. 92%, P＝0. 010) ;治疗14d后,与常规治疗组比较,丁基苯酞组美国国立卫生研究院卒中量表[NIHSS ,(9.47 ± 4. 24 )分比(6.12 ± 3.81 )分]评分显著降低,日常生活能力量表[Barthel指数, (45.27 ± 6.78)分比(63.19 ± 7.13)分]评分显著增加(P均＝0.001) ;随访时,与常规治疗组比较,丁基苯酞组简明精神状态检查量表[MMSE , (23.74 ± 4.82 )分比(27. 56 ± 4. 91 )分]评分、蒙特利尔认知评估量表[MoCA , (24.07 ± 4.98)分比(27.96 ± 5.07)分]评分及简明健康调查问卷(SF—36)中生理功能、社会功能、精神健康、总体健康四个维度评分均显著增加(P均＝0.001).结论:丁基苯酞注射液可显著提高急性脑梗死患者的临床疗效,改善患者的神经功能,提高患者的认知功能与生活质量.%Objective :To assess therapeutic effect of butylphthalide injection on acute cerebral infarction (ACI ) and its influence on neurological function and quality of life (QOL).Methods : A total of 106 ACI patients were enrolled from our hospital ,randomly and equally divided into routine treatment group and butylphthalide group (received bu—tylphthalide injection based on routine treatment ).After 14d treatment ,clinical therapeutic effect was assessed in two groups ;neurological function indexes were compared between two groups before and after treatment .Cognitive function and QOL were compared between two groups before and during follow—up .Results : Total effective rate of butylphthalide group was significantly higher than that of routine treatment group (88.68% vs.67.92%, P＝0.010).Compared with routine treatment group after 14d treatment ,there was significant reduction in score of U—nited States National Institutes of Health Stroke Score [NIHSS ,(9.47 ± 4. 24) scores vs .(6. 12 ± 3.81) scores] ,and significant rise in score of activity of daily living scale [Barthel index ,(45. 27 ± 6.78 ) scores vs .(63.19 ± 7.13 ) scores] in butylphthalide group , P＝0.001 both .Compared with routine treatment group during follow—up ,there were significant rise in scores of mini—mental state examination [MMSE ,(23.74 ± 4.82) scores vs.(27.56 ± 4.91) scores] ,Montreal Cognitive Assessment [MoCA , (24.07 ± 4. 98 ) scores vs .(27.96 ± 5.07 ) scores] and physical functioning ,social functioning ,mental health and general health dimension of the medical outcomes study 36—item short—form heath survey (SF—36) in butylphthalide group , P＝0. 001 all.Conclusion : Butylphthalide injection can significantly improve therapeutic effect ,neurological function ,cognitive function and quality of life in patients with acute cerebral infarction .