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目的 观察丁苯酞注射液及软胶囊序贯治疗急性脑梗死的临床疗效及其对血浆脂蛋白磷脂酶A2的影响.方法 选取脑梗死患者120例为研究对象,采用数字表法随机分为观察组64例、对照组56例.对照组给予常规治疗+安慰剂,观察组在常规治疗基础上序贯给予丁苯酞注射液及丁苯酞软胶囊治疗.治疗前后检测两组血浆脂蛋白磷脂酶A2,并进行美国国立卫生研究院卒中量表(NIHSS)评分,比较其神经功能缺损改善情况,并记录两组不良反应.结果 治疗前,两组NIHSS评分、血浆脂蛋白磷脂酶A2水平差异均无统计学意义(均P＞0.05).治疗后,观察组NIHSS评分、血浆脂蛋白磷脂酶A2水平分别为(6.40±5.22)分、(203.26±29.33) ng/mL,对照组分别(8.59±6.22)分、(253.10±52.99) ng/mL,两组差异均有统计学意义(t=-1.36、-2.089,P=0.039、0.000);观察组总有效率为90.6％,高于对照组的67.9％,两组差异有统计学意义(x2=9.676,P=0.002);两组不良反应发生率差异无统计学意义(P＞0.05).结论 丁苯酞序贯治疗急性脑梗死能改善患者的神经功能,降低血浆脂蛋白磷脂酶A2水平,抑制血管的炎性反应,改善患者预后.

Objective To observe the effect of sequential therapy of butylphthalide injection and soft capsules for acute cerebral infarction and its influence on plasma lipoprotein phospholipase A2.Methods 120 patients with cerebral infarction were selected in the study,and they were divided into observation group (64 cases) and control group(56 cases) according to the digital table.The control group received conventional therapy plus placebo,the observation group received the sequential administration of butylphthalide injection and butylphthalide soft capsule treatment based on the conventional treatment.Before and after treatment,the plasma lipoprotein phospholipase A2 of the two groups was detected,and the National Institutes of Health Stroke Scale (NIHSS) was evaluated,compared neurological deficit improvement between the two groups and recorded adverse drug reactions of the two groups.Results There were no significant differences in NIHSS score and plasma lipoprotein phospholipase A2 level between the two groups before treatment(all P ＞ 0.05).After treatment,the NIHSS score of neurological impairment,plasma lipoprotein phospholipase A2 level in the observation group were (6.40 ± 5.22) points,(203.26 ± 29.33) ng/mL,those in the control group were (8.59 ± 6.22) points,(253.10 ± 52.99) ng/mL,the differences were statistically significant(t =-1.36,-2.089,P =0.039,0.000).The total effective rate of the observation group was 90.6％,which was higher than 67.9％ of the control group,the difference was statistically significant (x2 =9.676,P =0.002).The incidence rate of adverse reactions was similar in the two groups (P ＞ 0.05).Conclusion Sequential therapy of butylphthalide for acute cerebral infarction can improve the neurological function,decrease the level of plasma lipoprotein phospholipase A2,inhibit the inflammation of blood vessels,improve the prognosis of patients.