摘要
目的观察丁苯酞（NBP）治疗对急性缺血性卒中患者外周血内皮祖细胞（EPCs）水平及美国国立卫生研究院卒中量表（NIHSS）评分的影响；探讨其疗效及潜在机制。方法筛选首次发病48h内人院的急性缺血性卒中患者96例，按随机数字表分为NBP治疗组（NBP组）及安慰剂组。NBP治疗30d为1个疗程。流式细胞仪检测CD34＋／CD133＋／KDR＋标记细胞作为EPCs标志。分别检测入院当天（基线期）、治疗第7天、第14天和第30天外周血EPCs水平；并分别于上述时间点及病程90d时进行NIHSS评分。结果NBP组第7天、第14天、第30天时EPCs数量较基线期显著增加（均为P〈0．05）；且明显高于同期安慰剂组（分别为P〈0．05、P〈0．001、P〈0．001）。NBP组第7天NIHSS评分较基线期无明显改善（P〉0．05）；NBP组第14天、第30天NIHSS评分均明显低于基线期（均为P〈0．05）及同期安慰剂组（P〈0．05、P〈0．001）。NBP组第90天NIHSS评分较第30天有进一步降低（P〈0．05）。发病后3个月内NBP组缺血事件稍低于安慰剂组（P〉0．05）。两组随访期内均无严重不良事件发生。结论NBP治疗可显著改善急性缺血性卒中神经功能评分，可能通过提高外周血EPCs水平，改善预后，且安全性良好。
Objective To observe the effect of butylphthalide on the endothelial progenitor cells of peripheral blood and the score of NIH stroke scale in the acute ischemic stroke patients, and explore the efficacy and mechanism of NBP treatment on ischemic stroke. Methods 96 cases with first acute ischemic stroke within 48 hours of onset were admitted in our hospital and randomly divided into NBP group and placebo group. 30 days was a course of NBP treatment. EPCs were marked as CD34 ~/CD133 ~/KDR ＋ labeled cells by flow cytometry detection. EPCs levels were detected at baseline, 7 days, 14 days and 30 days after therapy in all the patients. NIHSS scores were also detected at the same time and 90 days^tlafter onset. Results The levels of EPCs of NBP group was significantly increased at 7 days, 14 days and 30 days after therapy when compared with those of baseline （ P 〈 0. 05, respectively） and they were also markedly higher than those of placebo group in the same period （P 〈 0. 05, P 〈 0. 001, P 〈 0. 001 ）. NIHSS score was not obviously changed after 7days NBP treatment （P 〉 0. 05 ）, but it was continuously decrease at 14 days, 30 days and 90 days. Also it was significantly lower than that of placebo group at 14 days and 30 days in NBP group （ P 〈 0. 05, respectively）. During the follow - up period （ within three months after onset ） isehemie events in NBP group were slightly lower than those of placebo group （ P 〉 O. 05 ）. There were no serious adverse effects in the two groups. Conclusions NBP treatment could obviously improve neurological score in the acute ischemie stroke patients and it is possibly by increase the levels of circulating EPCs to improve the prognosis. It is well tolerated.
出处
《中华神经外科杂志》
CSCD
北大核心
2012年第10期1057-1061,共5页
Chinese Journal of Neurosurgery
基金
国家973创伤项目（2012CB518106）
关键词
内皮祖细胞
缺血性卒中
丁苯酞
Endothelial progenitor cells
Acute ischemie stroke
Butylphthalide
作者简介
通信作者：惠国祯，Email：guozhen-hui@163．com
