摘要
目的:观察烟雾病合并脑梗死患者在应用丁苯酞序贯治疗(丁苯酞注射液治疗2周及丁苯酞软胶囊治疗2周~3个月)后脑灌注量及侧支循环相关参数变化情况。方法:选取216例烟雾病合并脑梗死患者,研究组100例诊断后2周内采用数字减影脑血管造影(DSA)检查或者头部脑动脉CT血管造影-最大密度投影(CTA-MIP)检查患者的侧支循环情况。脑梗死发病2周内给予抗栓(阿司匹林肠溶片及阿托伐他汀钙片)+丁苯酞注射液治疗,2周~3个月应用抗栓+丁苯酞软胶囊治疗。对照组116例均给予单纯抗栓治疗。两组患者分别在入院3天内、1个月及3个月时进行CT灌注成像检查。比较两组患者局部脑血流量(rCBF)、局部脑血容量(rCBV)、平均通过时间(MTT)、达峰时间(TTP)的变化;并在3个月时通过DSA检查或头部CTA-MIP检查了解患者的侧支代偿改善情况,观察大脑前或大脑后动脉软脑膜支吻合及新生血管的发生率。结果:治疗1个月时,两组患者rCBF、rCBV、MTT、TTP较入院时均有所改善,且两组患者MTT有统计学差异(P<0.05);治疗3个月时,两组患者rCBF、rCBV、MTT、TTP较入院时均有所改善,且两组患者rCBF、MTT、TTP均有统计学差异(P<0.05)。结论:丁苯酞序贯治疗对烟雾病合并脑梗死患者脑血管灌注量变化可起到一定的改善作用,患者侧支循环代偿情况有所改善。
Objective:To observe the changes of cerebral perfusion and collateral circulation parameters in patients with moyamoya disease complicated with cerebral infarction after sequential treatment with butylphthalide(2 weeks with butylphthalide injection and 2 weeks to 3 months with butylphthalide soft capsule).Methods:216 patients with moyamoya disease complicated with cerebral infarction were included in the study and divided into two groups,study group and control group.DSA or head CTA-MIP examination were provided to 100 patients(study group)within 2 weeks after diagnosis to check the status of collateral circulation.Within 2 weeks after the onset of cerebral infarction,patients in the study group were given antithrombotic(aspirin enteric-coated tablets and atorvastatin calcium tablets)and butylphthalide injection,as well as antithrombotic and butylphthalide soft capsules for 2 weeks to 3 month.In the control group,116 patients were given antithrombotic treatment alone.For all patients,CT perfusion imaging was performed within 3 days,after 1 month and 3 months of admission.The changes of regional cerebral blood flow velocity(rCBF),regional cerebral blood volume(CBV),mean transit time(MTT)and peak time(TTP)were compared between the two groups.In 3 month,the improvement of collateral compensation was checked by DSA or head CTA-MIP.And the incidence of anterior or posterior cerebral artery pial anastomosis and neovascularization was observed.Results:After 1 month of treatment,scores of rCBF,rCBV,MTT,TTP were improved in both groups,with significant difference of MTT observed between two groups(P<0.05).After 3 month treatment,improvement were found in rCBF,rCBV,MTT,TTP in both groups,with obvious difference between groups in rCBF,MTT and TTP(P<0.05).Conclusion:Sequential treatment with butylphthalide in patients with moyamoya disease and cerebral infarction can improve the cerebral vascular perfusion and the compensation of collateral circulation.
作者
刘丹
王桂贤
LIU Dan;WANG Gui-xian(Zhumadian Central Hospital,Zhumadian 463000,China)
出处
《中国合理用药探索》
CAS
2020年第8期41-44,共4页
Chinese Journal of Rational Drug Use
关键词
烟雾病
脑梗死
丁苯酞
脑灌注量
侧支循环
moyamoya disease
cerebral infarction
butylphthalide
cerebral perfusion volume
collateral circulation
作者简介
刘丹,女,副主任医师,研究方向:主要从事神经内科临床工作及新药研究。联系电话:(0396)2726128,E-mail:zmdld820912@163.com。
