2018 年第 11 期 第 13 卷

普罗布考对动脉粥样硬化性脑梗死患者神经功能和人甲壳质酶蛋白40及血脂水平的影响

Effect of probucol on neurological function, chitin enzyme protein-40 and blood lipid in atherosclerotic cerebral infarction patients

作者：魏雨雨陈铮立

英文作者：

单位：310003杭州市红十字会医院神经外科（魏雨雨）；310013杭州，解放军第一一七医院神经外科（陈铮立）

英文单位：

关键词：动脉粥样硬化性脑梗死；普罗布考；人甲壳质酶蛋白40；Brathel指数；神经功能

英文关键词：

• 摘要：

• 【摘要】目的    探讨普罗布考对动脉粥样硬化性脑梗死（ACI）患者神经功能、人甲壳质酶蛋白40（YKL-40）和血脂水平等的影响。方法    选取2014年7月至2016年7月杭州市红十字会医院收治的ACI患者145例，采用随机数字表法随机分为2组，对照组72例接受阿司匹林肠溶片和阿托伐他汀钙治疗；观察组73例在对照组的基础上联合普罗布考治疗；比较2组患者治疗前及治疗90 d后的血清YKL-40、血脂及颈动脉内膜中层厚度（CIMT），比较治疗前后美国国立卫生研究院卒中量表（NIHSS）评分及Brathel指数的变化，并对2组的临床疗效进行比较。结果    治疗前，2组患者的CIMT及血脂水平比较差异均无统计学意义（均P＞0.05）。治疗90 d后，2组患者的CIMT、总胆固醇及低密度脂蛋白胆固醇均低于治疗前、且观察组低于对照组，高密度脂蛋白胆固醇均高于治疗前、且观察组高于对照组，差异均有统计学意义（均P＜0.05）。治疗前，2组患者的YKL-40、NIHSS评分及Brathel指数比较差异均无统计学意义（均 P＞0.05）。治疗90 d后，2组患者的YKL-40、NIHSS评分均低于治疗前、且观察组低于对照组［(52±20)ng/L比（77±25）ng/L，(11±4)分比（17±5）分］，Brathel指数均高于治疗前、且观察组高于对照组［(84±13)比（70±12）］，差异均有统计学意义（均P＜0.05）。治疗90 d后观察组的总有效率高于对照组［94.5%(69/73)比70.8%（51/72）］，差异有统计学意义（χ2=14.254，P＜0.001）。结论    普罗布考可显著降低ACI患者的YKL-40、血脂水平、CIMT及NIHSS评分，提高患者日常生活活动能力。

• 【Abstract】Objective    To explore the effect of probucol on neurological function, chitin enzyme protein-40(YKL-40) and blood lipid level in atherosclerotic cerebral infarction(ACI) patients. Methods    A total of 145 ACI patients admitted in Hangzhou Red Cross Hospital from July 2014 to July 2016 were randomly divided into control group(n＝72) and observation group(n＝73). The control group was treated with aspirin enteric-coated tablets and atorvastatin calcium. The observation group was treated with probucol on the basis of the control group. Serum YKL-40 and lipid level, carotid intima-media thickness(CIMT), the National Institutes of Health Stroke Scale(NIHSS) score and Brathel index were analyzed before and after treatment. Clinical therapeutic effect was analyzed after treatment. Results    Before treatment, there were no significant differences of CIMT and blood lipid level between groups(P＞0.05). After 90 days of treatment, CIMT, levels of total cholesterol(TC) and low-density lipoprotein cholesterol（LDL-C） were significantly lower and high-density lipoprotein cholesterol（HDL-C） was significantly higher than those before treatment in both groups; CIMT, TC and LDL-C in observation group were significantly lower and HDL-C was significantly higher than those in control group（all P＜0.05）. Before treatment, there were no significant differences of serum YKL-40 level, NIHSS score and Brathel index between groups(P>0.05). After 90 days of treatment, YKL-40 level and NIHSS score were significantly lower and Brathel index was significantly higher than those before treatment in both groups; YKL-40 level and NIHSS score in observation group were significantly lower and Brathel index was significantly higher than those in control group［(52±20)ng/L vs （77±25）ng/L, (11±4) vs （17±5）, (84±13) vs （70±12）］（all P＜0.05）. The total effective rate in observation group was significantly higher than that in control group［94.5%(69/73) vs 70.8%(51/72)］(χ2=14.254， P＜0.01). Conclusion    Probucol can significantly lower YKL 40, blood lipid, CIMT, NIHSS score and improve activities of daily living in ACI patients.