【摘要】 目的 分析丁苯酞与鼠神经生长因子联合双抗疗法治疗老年急性脑梗死患者的临床疗效，并基于血栓前状态指标和血清氧化型LDL(ox-LDL)、可溶性细胞间黏附分子-1(sICAM-1)、一氧化氮探讨其治疗机制。方法 选取150例老年急性脑梗死患者，随机分为观察组与对照组，各75例。其中对照组采用双抗疗法治疗，观察组采用丁苯酞与鼠神经生长因子联合双抗疗法治疗，均治疗4周。比较两组患者临床疗效，以及治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、血栓前状态指标[血小板最大聚集率(MPAR)、D-二聚体、纤维蛋白原(FIB)]及血清ox-LDL、sICAM-1、一氧化氮水平。评估发病3个月后两组患者的预后情况及治疗期间两组不良反应发生情况。结果 治疗后，观察组的NIHSS评分、MPAR、血浆D-二聚体水平、血浆FIB水平、血清ox-LDL水平、血清sICAM-1水平低于治疗前及对照组，血清一氧化氮水平高于治疗前及对照组，临床疗效优于对照组(均P<0.05)。发病3个月后，观察组改良Rankin量表评分低于对照组，改良Barthel指数评分高于对照组(均P<0.05)。两组患者不良反应发生率差异无统计学意义(P>0.05)。结论 丁苯酞与鼠神经生长因子联合双抗疗法治疗老年急性脑梗死的疗效确切，可以减轻患者的神经功能缺损、改善预后，其机制可能与丁苯酞、鼠神经生长因子可以进一步改善血栓前状态及下调血清ox-LDL、sICAM-1的表达水平和上调血清一氧化氮的表达水平有关。更多还原

【Abstract】 Objective To analyze the clinical efficacy of butylphthalide combined with mouse nerve growth factor dual antibody therapy in the treatment of elderly patients with acute cerebral infarction, and to explore its therapeutic mechanism based on pre-thrombotic state indices and serum oxidized LDL(ox-LDL), soluble intercellular adhesion molecule-1(sICAM-1) and nitric oxide. Methods A total of 150 elderly patients with acute cerebral infarction were selected and randomly divided into observation group or control group, with 75 cases in each group, among which the control group was treated with dual antibody therapy, while the observation group was treated with butylphthalide combined with mouse nerve growth factor dual antibody therapy. Both groups were treated for 4 weeks. The clinical efficacy, and the pre-and post-treatment National Institutes of Health Stroke Scale(NIHSS) score, pre-thrombotic state indices(maximum platelet aggregation rate [MPAR], D-dimer, fibrinogen [FIB]), and serum ox-LDL, sICAM-1 and nitric oxide levels were compared between the two groups. The prognosis of the two groups 3 months after onset and the occurrence of adverse reactions during treatment were compared between the two groups. Results After treatment, the NIHSS score, MPAR, plasma D-dimer and FIB levels, as well as serum ox-LDL and sICAM-1 levels of the observation group were lower than those of the control group, whereas the serum nitric oxide level was higher than that of the control group, and the clinical efficacy of the observation group was superior to that of the control group(all P<0.05). Three months after onset, the modified Rankin scale score in the observation group was lower than that in the control group, and the modified Barthel index score in the observation group was higher than that in the control group(all P<0.05). There was no statistically significant difference in the incidence rate of adverse reactions between the two groups(P>0.05). Conclusion Butylphthalide combined with mouse nerve growth factor dual antibody therapy for the treatment of elderly patients with acute cerebral infarction exerts a definite efficacy, which can alleviate nerve function defect, improve prognosis of patients; furthermore, its mechanism may be related to that butylphthalide and mouse nerve growth factor can further ameliorate pre-thrombotic state, and down-regulate serum ox-LDL, sICAM-1 expressions, as well as up-regulate the expression of serum nitric oxide.更多还原