丹参川芎嗪注射液对缺血性脑中风患者同型半胱氨酸、高敏C反应蛋白和血脂水平的影响及疗效观察

陈国宁+林泽辉+杜永明

[摘要] 目的 探讨丹参川芎嗪注射液对缺血性脑卒中患者血清中同型半胱氨酸、高敏C反应蛋白和血脂水平的影响以及临床疗效观察。 方法 选取2014年2月～2016年11月在广州中医药大学附属海南省中医院急诊科治疗的100例缺血性脑卒中患者，根据治疗方案分为观察组和对照组，每组各50例。对照组给予常规治疗，观察组加用丹参川芎嗪注射液。比较两组患者血清中同型半胱氨酸、高敏C反应蛋白和血脂水平，并评估两组患者的临床疗效和NIHSS评分。 结果 治疗后观察组患者血清中同型半胱氨酸、高敏C反应蛋白、总胆固醇、三酰甘油和脂蛋白a水平均明显低于对照组，差异有统计学意义（P < 0.05）。观察组临床疗效和NIHSS评分均优于对照组，差异有统计学意义（P < 0.05）。 结论 丹参川芎嗪注射液能降低缺血性脑卒中患者血清同型半胱氨酸、高敏C反应蛋白和血脂水平，提高临床疗效，优化患者神经功能改善。

[关键词] 缺血性脑卒中；丹参川芎嗪注射液；同型半胱氨酸；高敏C反应蛋白；血脂；临床疗效

[中图分类号] R734 [文献标识码] A [文章编号] 1673-7210（2018）01（a）-0076-04

[Abstract] Objective To explore the effect of Salvia Tetramethylpyrazine Injection on serum homocysteine， high-sensitivity C-reactive protein and lipid levels in ischemic stroke and clinical efficacy. Methods From February 2014 to November 2016， 100 patients with ischemic stroke in the emergency department of Chinese Medicine Hospital of Hainan Province， Guangzhou University of Chinese Medicine were selected and divided into treatment group and control group according to therapeutic schedule， with 50 cases in each group. The control group was treated with conventional treatment， while the treatment group was treated Salvia Tetramethylpyrazine Injection on the basis of control group. The serum homocysteine， high-sensitivity C-reactive protein， lipid levels， clinical efficacy， NIHSS score of the two groups were observed. Results After treatment， the levels of serum homocysteine， high-sensitivity C-reactive protein ， total cholesterol， triacylglycerol and lipoprotein （a） in the treatment group were lower than those in the control group， with statistically significant difference （ P < 0.05）. The NIHSS score and clinical efficacy of treatment group were significantly better than those of control group， with statistically significant difference （P < 0.05）. Conclusion Salvia Tetramethylpyrazine Injection can reduce the serum homocysteine， high sensitivity c-reactive protein and serum lipid levels in patients with ischemic stroke， improve the clinical efficacy and neurological function.

[Key words] Ischemic stroke； Salvia Tetramethylpyrazine Injection； Homocysteine； High-sensitivity C-reactive protein； Lipid； Clinical efficacy

缺血性脑卒中指脑血管狭窄或闭塞，导致其功能障碍而使脑组织发生缺血缺氧、软化甚至坏死，从而引起一系列相关症状的疾病，具有极高的病死率和致残率[1]。目前对于缺血性脑卒中的治疗以改善脑循环，改善患者临床症状，提高其生活质量为主[2]。同时，由于这类患者再发病率高，如何降低患者再次发作的危险性，特别是针对病因的治疗，显得尤为关键。动脉粥样硬化是该病最常见病变基础。而动脉粥样硬化与血清中同型半胱氨酸（homocysteine，Hcy）、高敏C反应蛋白（high-sensitivity C-reactive Protein，hs-CRP）的高水平以及血脂代謝紊乱等呈相关性[3]。丹参川芎嗪注射液的主要成分为丹参素和川芎嗪，具有改善微循环及保护血管内皮功能等重要作用[4]。为了探讨其对缺血性脑卒中患者血清中Hcy、hs-CRP和血脂水平以及治疗效果的影响，本研究对部分患者在常规治疗基础上加用丹参川芎嗪注射液，现将结果报道如下：endprint