论著
尤瑞克林联用丁苯酞对急性脑梗死患者的神经细胞因子及CXCL16、CD40L影响研究
程海冰
【摘要】 【摘要】目的 探讨尤瑞克林联用丁苯酞对急性脑梗死患者的神经细胞因子及CXCL16、CD40L影响。
【关键字】 尤瑞克林,丁苯酞,急性脑梗死,神经细胞因子,CXCL16,CD40L
中图分类号：文献标识码：文章编号：
[Abstract] Objective To investigate the effects of ulicline combined with butylphthalide on neurocytokines, CXCL16 and CD40L in patients with acute cerebral infarction. Methods Ninety patients with acute cerebral infarction admitted to our hospital from January 2015 to January 2017 were divided into two groups according to different treatment methods. The control group (n=45) was treated with butylphthalide, and the observation group (n=45) was treated with uricline on the basis of the control group. Both groups were given lipid regulation, blood sugar control, blood pressure control and blood pressure control. The patients in the observation group received intravenous drip of uricoline after routine treatment such as lowering intracranial pressure and inhibiting platelet, and then intravenous drip of butylphthalide. Both groups received continuous treatment for two weeks. Serum levels of cytokines [soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble cell adhesion factor-1 (sICAM-1), tumor necrosis factor-alpha (TNF-alpha), matrix metalloproteinase-9 (MMP-9)] and neurocytokines [neuron-specific enolase (NSE), neurogenesis] were compared between the two groups before and after treatment. The levels of long factor (NGF), neurotrophic factor (NTF) and high mobility group protein B1 (HMGB1), Fibulin-5 (Fibulin-5), soluble CD40 ligand (CD40L), CXC chemokine ligand 16 (CXCL16) were measured. Results After treatment, the serum levels of cytokines sVCAM-1, sICAM-1, TNF-alpha and MMP-9 in the observation group were significantly lower than those in the control group (P<0.05). After treatment, the levels of neurocytokine NSE in the observation group were significantly lower than those in the control group, and the levels of NGF and NTF in the observation group were significantly higher than those in the control group (P<0.05). After treatment, the levels of HMGB1, Fibulin-5, CD40L and CXCL16 in the observation group were significantly lower than those in the control group (P<0.05). Conclusion The combination therapy of Eurekrin and Butylphthalide can effectively stabilize the level of infarction-related factors, and the clinical effect is satisfactory, so it is worthy of clinical promotion.
脑梗死是缺血性脑卒中的简称，是因为各种原因导致局部脑组织缺血，致使其坏死而发生的相应神经功能缺失[1]。急性脑梗死为突发的脑血管闭塞，其病情严重，发展快，致残率高，死亡率高，其严重程度由脑中梗塞的范围和位置决定[2]，若不及时给予有效的治疗，会严重威胁患者的生命安全，所以及早诊断，及时治疗很有必要[3]。丁苯酞是一种抗脑缺血药物，研究显示其能有效改善脑血流灌注，进而促进神经功能修复[4]，尤瑞克林为一种人尿激肽原酶，能激活自身激肽原酶-激肽系统，并转化为胰激肽，进而促进合成及释放血管舒张素，改善血氧供给，及时修复神经功能缺损[5]。本研究就探讨两种药物合用治疗急性脑梗死的效果。
1 资料与方法
1.1 一般资料：选取我院（2015年1月至2017年1月）收治的急性脑梗死患者90例，均经MR或CT检查确诊，符合《中国急性期缺血性脑卒中诊治指南》诊断标准，根据不同治疗方法分为两组，对照组（n=45）给予丁苯酞治疗，其中男26例，女19例；年龄40~75岁，平均（62.54±5.24）岁；病程6~12 h，平均（7.63±1.57）h；发病部位：7例丘脑，5例脑干，7例颞顶叶，9例额颞叶，17例内囊；基础疾病：27例高脂血症，24例糖尿病，20例高血压；观察组（n=45）在对照组基础上给予尤瑞克林治疗，其中男25例，女20例；年龄40~75岁，平均（63.11±5.42）岁；病程6~12 h，平均（7.41±1.71）h；发病部位：8例丘脑，4例脑干，8例颞顶叶，8例额颞叶，17例内囊；基础疾病：28例高脂血症，28例糖尿病，21例高血压；两组患者一般资料对比无显著差异（P>0.05）。纳入标准：①符合急性脑梗死诊断标准；②患者及家属均知情研究；③对本研究药物无过敏者；④不能接受溶栓治疗者；排除标准：①心功能、肝肾功能、凝血功能障碍者；②恶性肿瘤者；③哺乳期妇女或孕妇。本研究所选病例经过伦理委员会批准。
