老年大动脉粥样硬化型脑梗死患者采用NBP与LIPost C联合治疗的效果分析

doi:10.3969/j.issn.1006-5725.2024.09.018

Abstract

Abstract:

Objective To analyze the joint efficacy of butylphthalide （NBP） and limb ischemic postconditioning （LIPost C） in the treatment of elderly patients with atherosclerotic cerebral infarction. Methods A total of 160 patients with large atherosclerotic cerebral infarction hospitalized in Bijie Hospital from October 2020 to October 2022 were divided into four groups： NBP， LIPost C， NBP + sham LIPost C， and NBP + LIPost C by the random number table method， with 40 cases in each group. Before and after one-month treatment， the four groups were compared in terms of collateral circulation evaluated by the leptomeningeal scoring （rLMC）， neurological function evaluated by the National Institutes of Health Stroke Scale （NIHSS）， limb function disability evaluated by the Modified Rankin Scale （MRS）， cognitive function evaluated by the Mini Mental State Scale （MMSE）， daily living ability evaluated by the Barthel Index， as well as the occurrence of bleeding adverse events. Results After one-month treatment， the four groups all showed an increase in the rLMC score， with the NBP + LIPost C group significantly higher than the other three groups （P < 0.05）， and a decrease in the scores of NIHSS and MRS at each time point， with the NBP + LIPost C group significantly lower than the other three groups （P < 0.05）. Additionally， the four groups demonstrated an increase in the MMSE score and Barthel index at each time point （P < 0.05）， with the NBP + LIPost C group higher than the other three groups （P < 0.05）. Moreover， all the four groups showed no statistically significant difference in the incidence of bleeding adverse events （P > 0.05）. Conclusion NBP combined with LIPost C can effectively promote the establishment of collateral circulation and the recovery of neurological function in elderly patients with atherosclerotic cerebral infarction. Meanwhile， it can improve their motor function， daily living ability， and cognitive function. Moreover， it has high safety.

Key words: butylphthalide injection, limb ischemic postconditioning, large artery atherosclerotic cerebral infarction, neurological function, cognitive function

CLC Number:

R743.3

Song LI,Xingyou HE,Dian HE,Bo WANG,Yu ZHAN,Jingjing. SUN. The joint efficacy of NBP and LIPost C in treatment of elderly patients with large atherosclerotic cerebral infarction[J]. The Journal of Practical Medicine, 2024, 40(9): 1286-1292.

Figures/Tables 6

Tab.1

Comparison of general data of four groups of patients"

组别	例数	年龄（ $x ˉ$ ± s，岁）	性别（例）		血管危险因素（例）
组别	例数	年龄（ $x ˉ$ ± s，岁）	男	女	吸烟史	饮酒史	高血压史	糖尿病病史	冠状动脉粥样硬化性心脏病病史	高脂血症
NBP组	40	73.23 ± 3.45	26	14	18	23	12	5	3	13
LIPost C组	40	74.08 ± 3.52	23	17	16	25	15	7	1	15
NBP+假LIPost C组	40	73.85 ± 3.60	22	18	17	22	12	6	1	16
NBP+LIPost C组	40	73.70 ± 3.63	25	15	15	21	13	5	1	12
χ²/F值		0.410	1.042		0.516	0.892	0.684	0.559	1.795	1.099
P值		0.746	0.791		0.915	0.827	0.877	0.906	0.729	0.777

Tab.1

Tab.2

Tab.3

Tab.4

Tab.5

Tab.6

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组别	例数	治疗前	治疗1个月	Z值	P值
NBP组	40	3.00（3.00，4.00）	13.00（12.00，14.75）	5.527	< 0.001
LIPost C组	40	3.00（3.00，4.00）	14.00（12.00，14.00）	5.529	< 0.001
NBP+假LIPost C组	40	3.00（3.00，4.00）	13.00（12.00，14.00）	5.525	< 0.001
NBP+LIPost C组	40	3.00（3.00，4.00）	16.00（15.00，17.00）^abc	5.523	< 0.001
H值		0.416	35.411
P值		0.937	< 0.001

组别	例数	治疗前	治疗1 d	治疗7 d	治疗1个月
NBP组	40	17.00（15.25，18.00）	14.00（13.00，15.00）^d	11.00（10.00，11.75）^de	7.00（6.25，8.00）^def
LIPost C组	40	18.00（17.00，18.00）	14.00（13.00，15.00）^d	11.00（10.00，12.00）^de	7.00（7.00，8.00）^def
NBP+假LIPost C组	40	16.00（15.00，18.00）	15.00（13.00，15.00）^d	11.00（11.00，12.75）^de	7.00（6.25，8.75）^def
NBP+LIPost C组	40	17.50（15.00，18.00）	14.00（13.00，15.00）^d	10.00（9.00，10.00）^abcde	6.00（6.00，7.00）^abcdef
χ²_组间/P值		18.499/< 0.001
χ²_时点/P值		5 302.124/< 0.001
χ²_{组间与时点交互}/P值		27.906/< 0.001

组别	例数	治疗前	治疗1 d	治疗7 d	治疗1个月
NBP组	40	3.00（3.00，4.00）	3.00（3.00，3.00）^d	3.00（2.00，3.00）^de	2.00（2.00，2.00）^def
LIPost C组	40	3.00（3.00，4.00）	3.00（3.00，3.75）^d	2.00（2.00，3.00）^de	2.00（2.00，2.00）^adef
NBP+假LIPost C组	40	3.00（3.00，4.00）	3.00（3.00，3.75）^d	2.50（2.00，3.00）^de	2.00（2.00，2.00）^def
NBP+LIPost C组	40	3.00（3.00，4.00）	3.00（3.00，3.00）^d	2.00（2.00，2.00）^abcde	1.00（1.00，1.00）^abcdef
χ²_组间/P值		61.125/< 0.001
χ²_时点/P值		2 101.712/< 0.001
χ²_{组间与时点交互}/P值		114.448/< 0.001

组别	例数	治疗前	治疗1 d	治疗7 d	治疗1个月
NBP组	40	13.23 ± 2.71	14.18 ± 2.57	16.20 ± 2.44^de	19.30 ± 2.37^def
LIPost C组	40	13.18 ± 2.63	14.13 ± 2.45	16.50 ± 2.59^de	19.45 ± 2.18^def
NBP+假LIPost C组	40	13.05 ± 2.84	14.05 ± 2.61	16.43 ± 2.55^de	19.30 ± 2.11^def
NBP+LIPost C组	40	13.25 ± 2.69	14.90 ± 2.35	18.15 ± 2.79^abcde	22.30 ± 2.23^abcdef
F_组间/P值		12.800/< 0.001
F_时点/P值		234.039/< 0.001
F_{组间与时点交互}/P值		2.418/0.011

组别	例数	治疗前	治疗1 d	治疗7 d	治疗1个月
NBP组	40	58.25 ± 4.15	60.23 ± 4.20	65.25 ± 5.01^de	70.28 ± 5.08^def
LIPost C组	40	58.75 ± 4.43	60.80 ± 4.36	65.75 ± 5.12^de	69.73 ± 5.26^def
NBP+假LIPost C组	40	58.50 ± 4.33	60.08 ± 4.21	65.00 ± 5.09^de	69.70 ± 5.28^def
NBP+LIPost C组	40	58.63 ± 4.29	61.30 ± 4.40	68.80 ± 4.83^abcde	75.40 ± 5.36^abcdef
F_组间/P值		12.883/< 0.001
F_时点/P值		252.582/< 0.001
F_{组间与时点交互}/P值		2.597/0.007

The joint efficacy of NBP and LIPost C in treatment of elderly patients with large atherosclerotic cerebral infarction

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