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丁苯酞对脑小血管病患者血管内皮功能及认知功能的影响(1)
http://www.100md.com 2017年12月25日 中国医学创新 2017年第36期
     【摘要】 目的:研究丁苯酞对脑小血管病(CSVD)患者血管内皮功能及认知功能的影响。方法:纳入符合CSVD诊断并按计划完成的脑小血管病患者,将患者随机分为对照组和试验组。对照组(46例)采用常规治疗,试验组(42例)在常规治疗基础上加服丁苯酞胶囊。流式细胞仪检测外周血EPCs数目;ELISA检测血清ICAM-1、ET-1水平;MoCA量表评估认知功能;Barthel指数评估日常生活活动能力,比较两组患者以上指标的变化情况。结果:治疗前,两组EPCs数目、ICAM-1及ET-1水平比较,差异均无统计学意义(P>0.05)。治疗12周时,试验组EPCs数目高于对照组及治疗前,差异均有统计学意义(P<0.05);试验组ICAM-1及ET-1水平均低于对照组及治疗前,差异均有统计学意义(P<0.05)。治療12周时,试验组MoCA评分及Barthel指数均高于对照组及治疗前,差异均有统计学意义(P<0.05)。试验组治疗12周时的MoCA评分与EPCs、ICAM-1及ET-1的变化幅度均呈正相关(P<0.05)。结论:丁苯酞能改善CSVD患者血管内皮功能和认知功能,可能与增加外周血EPCs数目、有效调控血清ICAM-1及ET-1表达有关。

    【关键词】 丁苯酞; 脑小血管病; 内皮祖细胞; 细胞间黏附分子-1; 内皮素-1

    【Abstract】 Objective:To study the effect of Butylphthalide on vascular endothelial function and cognitive function in patients of cerebral small vessel disease(CSVD).Method:Patients with small cerebral vasculopathy diagnosed according to CSVD and completed according to the plan were randomly divided into two groups:the control group and experimental group.The control group (46 cases) was received routine treatment,the experimental group (42 cases) was treated with Butylphthalide Soft Capsules on the basis of routine treatment.The number of EPCs was detected by flow cytometry,serum ICAM-1 and ET-1 levels were detected by ELISA,assessment of cognitive function by MoCA scale,Barthel index for assessment of activities of daily living,the changes of the above indexes in the two groups were compared.Result:Before treatment,there were no significant differences in the levels of EPCs,ICAM-1 and ET-1 between the two groups(P>0.05).At 12 weeks of treatment,the number of EPCs was higher than that in the control group and before treatment,the differences were statistically significant(P<0.05);the levels of ICAM-1 and ET-1 in the experimental group were lower than those in the control group and before treatment,the differences were statistically significant(P<0.05).At 12 weeks after treatment,the MoCA score and Barthel index in the experimental group were higher than those in the control group and before treatment,the differences were statistically significant(P<0.05).At 12 weeks after treatment,the MoCA score of the experimental group was positively correlated with the changes of EPCs,ICAM-1 and ET-1(P<0.05).Conclusion:Butylphthalide can improve the vascular endothelial function and cognitive function in patients with CSVD,which may be related to increasing the number of EPCs in peripheral blood,and effectively regulating the expression of serum ICAM-1 and ET-1.

    【Key words】 Butylphthalide; Cerebral small vessel disease; Endothelial progenitor cell; Intercellular adhesion molecule-1; Endothelin-1, http://www.100md.com(陆冰)
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