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目的探讨丁苯酞联合前列地尔治疗缺血性脑卒中的临床疗效及对超敏C反应蛋白(hs-CRP)的影响。方法收集2014年1月—2016年3月河南科技大学第一附属医院收治的85例缺血性脑卒中患者,随机分为对照组(43例)和观察组(42例)。两组患者均接受常规治疗,对照组在常规治疗基础上给予注射用前列地尔10μg静脉推注,1次/d。观察组在对照组的基础上加用丁苯酞胶囊0.2 g/次,3次/d,顿服。两组患者均连续治疗14 d。观察比较两组治疗前后的神经功能缺损评分(NIHSS)、日常生活自理能力量表(ADL)、hs-CRP、凝血功能指标的变化,以及临床疗效。结果治疗14 d后,两组的NIHSS、ADL评分、hs-CRP水平均有明显改善,同组治疗前后比较差异有统计学意义(P<0.05)。观察组的NIHSS评分显著低于对照组,ADL评分明显高于对照组,且hs-CRP水平明显低于对照组,组间比较差异有统计学意义(P<0.05)。治疗前,两组的凝血功能指标比较差异无统计学意义。治疗14 d后,两组的凝血酶原时间(PT)、D-二聚体(DD)及纤维蛋白酶原(FIB)均较治疗前有明显改善,同组治疗前后比较差异有统计学意义(P<0.05);且观察组的PT显著高于对照组,DD和FIB明显低于对照组,组间比较差异有统计学意义(P<0.05)。此外,观察组患者的临床治疗有效率(90.5%)显著高于对照组(72.1%),差异具有统计学意义(P<0.05)。结论相较于前列地尔单一用药,联合丁苯酞治疗能更好改善缺血性脑卒中患者的神经功能、日常生活能力及凝血功能,抑制hs-CRP水平,临床疗效显著。
Objective To investigate the clinical efficacy of butylphthalide combined with alprostadil in the treatment of ischemic stroke and its effect on hs-CRP. Methods A total of 85 ischemic stroke patients admitted from the First Affiliated Hospital of Henan University of Science and Technology from January 2014 to March 2016 were randomly divided into control group (43 cases) and observation group (42 cases). Both groups received routine treatment. The control group received 10μg of alprostadil for injection on the basis of routine treatment once a day. Observation group in the control group based on the use of butylphthalide capsules 0.2 g / time, 3 times / d, Dayton clothes. Two groups of patients were treated for 14 days. The changes of NIHSS, ADL, hs-CRP, coagulation index and the clinical curative effect of the two groups before and after treatment were observed and compared. Results After 14 days of treatment, the levels of NIHSS, ADL and hs-CRP in both groups were significantly improved. There was significant difference between the two groups before and after treatment (P <0.05). The NIHSS score of the observation group was significantly lower than that of the control group. The ADL score was significantly higher than that of the control group, and the hs-CRP level was significantly lower than that of the control group. There was significant difference between the two groups (P <0.05). Before treatment, there was no significant difference in coagulation function between the two groups. After 14 days of treatment, the prothrombin time (PT), D-dimer (DD) and fibrinogen (FIB) in both groups were significantly improved compared with those before treatment, and the difference was statistically significant before and after treatment P <0.05). The PT in the observation group was significantly higher than that in the control group, and DD and FIB were significantly lower than those in the control group. There was significant difference between the two groups (P <0.05). In addition, the clinical treatment efficiency (90.5%) in observation group was significantly higher than that in control group (72.1%), the difference was statistically significant (P <0.05). Conclusion Compared with single administration of alprostadil, combination of butylphthalide treatment can better improve the neurological function, daily living ability and blood coagulation function, and inhibit the level of hs-CRP in patients with ischemic stroke. The clinical efficacy is significant.