磷脂酰丝氨酸软胶囊辅助血管内治疗在缺血性卒中患者中的应用价值

doi:10.3760/cma.j.issn.1007-1245.2024.03.013

摘要/Abstract

摘要：

目的　观察磷脂酰丝氨酸软胶囊辅助血管内治疗（EVT）在缺血性卒中患者中的应用价值。方法　本研究为随机对照试验，前瞻性选取2021年1月至2023年1月南阳医学高等专科学校第一附属医院收治的123例缺血性卒中患者作为研究对象，采用随机数字表法分为联合组（63例）和对照组（60例）。对照组男32例、女28例，年龄（61.22±5.33）岁，实施常规治疗及EVT；联合组男33例、女30例，年龄（60.61±5.11）岁，采用磷脂酰丝氨酸软胶囊辅助EVT。对比两组患者血管内皮细胞功能、血小板功能、凝血功能改善情况及神经功能康复情况。采用t检验、χ²检验。结果　治疗前，两组患者血管内皮细胞损伤标志物、血小板活性指标、凝血指标及神经功能指标比较，差异均无统计学意义（均P>0.05）。治疗后，联合组内皮素-1（ET-1）［（50.11±10.26）ng/L］、血栓调节蛋白（TM）［（30.61±5.37）μg/L］、血管性假血友病因子（VWF）［（90.25±10.33）%］、β-血小板球蛋白（β-TG）［（15.28±5.17）μg/L］、颗粒膜蛋白CD62P［（56.32±10.41）%］、CD63［（10.44±3.65）%］、D-二聚体（D-D）［（188.45±50.61）μg/L］、凝血因子Ⅱ（FVⅡ）［（122.36±20.61）%］、凝血因子Ⅶ（FVⅦ）［（105.25±20.71）%］均低于对照组［（56.28±10.32）ng/L、（33.49±5.28）μg/L、（96.27±10.15）%、（18.33±5.41）μg/L、（61.55±10.28）%、（12.41±3.62）%、（211.27±50.66）μg/L、（135.44±20.66）%、（120.33±20.71）%］，差异均有统计学意义（t=3.324、2.998、3.258、3.197、2.802、3.004、2.498、3.514、4.037，均P<0.05）。在不同治疗方案下，联合组治疗3 d、7 d、14 d后的美国国立卫生研究院卒中量表（NIHSS）评分均低于对照组［（25.22±5.17）分比（28.61±5.47）分、（21.44±5.28）分比（24.19±5.26）分、（18.45±5.33）分比（21.32±5.14）分］，差异均有统计学意义（t=3.534、2.893、3.037，均P<0.05）。结论　磷脂酰丝氨酸软胶囊辅助EVT能有效减轻缺血性卒中患者血管内皮损伤，抑制血小板活性，对改善凝血功能、促进脑神经功能康复均有积极作用。

关键词:

缺血性卒中, 血管内治疗, 磷脂酰丝氨酸软胶囊, 血管内皮细胞功能, 凝血功能

Abstract:

Objective To observe the value of phosphatidylserine soft capsules and intravascular treatment (EVT) in the treatment of patients with ischemic stroke. Methods This was a prospective study. One hundred and twenty-three patients with ischemic stroke treated at First Hospital, Nanyang Medical College from January 2021 to January 2023 were selected as the study objects, and were divided into a combined group (63 cases) and a control group (60 cases) by the random number table method. There were 32 males and 28 females in the control group; they were (61.22±5.33) years old. There were 33 males and 30 females in the combined group; they were (60.61±5.11) years old. The control group took routine treatment and EVT. The combined group took phosphatidylserine soft capsules and EVT. The improvement of vascular endothelial cell function, platelet function, and coagulation function and neurological rehabilitation of the two groups were compared. t and χ² tests were applied. Results Before the treatment, there were no statistical differences in vascular endothelial cell injury markers, platelet activity indicators, coagulation indicators, and brain nerve function indicators between the two groups (all P>0.05). After the treatment, the levels of endothelin-1 (ET-1), thrombomodulin (TM), von Willebrand factor (vWF), β-thromboglobulin (β-TG), granule membrane protein CD62P, CD63, D-dimer (D-D), coagulation factor Ⅱ (FVⅡ), and coagulation factor Ⅶ (FVⅦ) in the combined group were lower than those in the control group [(50.11±10.26) ng/L vs. (56.28±10.32) ng/L, (30.61±5.37) μg/L vs. (33.49±5.28) μg/L, (90.25±10.33)% vs. (96.27±10.15)%, (15.28±5.17) μg/L vs. (18.33±5.41) μg/L, (56.32±10.41)% vs. (61.55±10.28)%, (10.44±3.65)% vs. (12.41±3.62)%, (188.45±50.61) μg/L vs. (211.27±50.66) μg/L, (122.36±20.61)% vs. (135.44±20.66)%, (105.25±20.71)% vs. (120.33±20.71)%], with statistical differences (t=3.324, 2.998, 3.258, 3.197, 2.802, 3.004, 2.498, 3.514, and 4.037; all P<0.05). Under different treatment regimens, the scores of National Institutes of Health Stroke Scale (NIHSS) 3, 7, and 14 after the treatment in the combined group were lower than those in the control group [(25.22±5.17) vs. (28.61±5.47), (21.44±5.28) vs. (24.19±5.26), and (18.45±5.33) vs. (21.32±5.14)], with statistical differences (t=3.534, 2.893, and 3.037; all P<0.05). Conclusion Phosphatidylserine soft capsules assisted with EVT for patients with ischemic stroke can effectively alleviate their vascular endothelial damage, inhibit platelet activity, improve their coagulation function, and promote their recovery of brain nerve function.

Key words:

Intravascular treatment, Ischemic stroke, Phosphatidylserine soft capsules, Vascular endothelial cell function, Coagulation function

田萌冯涛庄卫生.

磷脂酰丝氨酸软胶囊辅助血管内治疗在缺血性卒中患者中的应用价值 [J]. 国际医药卫生导报, 2024, 30(3): 414-418.

Tian Meng, Feng Tao, Zhuang Weisheng.

Phosphatidylserine soft capsules and intravascular treatment in treatment of patients with ischemic stroke [J]. International Medicine and Health Guidance News, 2024, 30(3): 414-418.

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