疏血通注射液对急性脑梗死患者血脂的影响及作用机制

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目的:探讨疏血通注射液对急性脑梗死患者血脂的干预作用及血清超敏C-反应蛋白(hs-CRP)、脂联素(APN)、氧化低密度脂蛋白(ox-LDL)和肿瘤坏死因子-α(TNF-α)的影响。方法:67例患者采用随机按住院前后分为对照组22例和观察组45例。对照组给予西医常规治疗,降脂采用阿托伐他汀钙片,10 mg/次,1次/d,晚饭后服用。观察组在对照组治疗的基础上加用疏血通注射液,6 mL/次,静脉滴注,1次/d,两组疗程均为14 d。于第0,7,14天评价采用美国国立卫生院卒中(NIHSS)量表评估神经功能缺损严重程度;检测治疗前后甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)水平;采用酶联免疫吸附法检测超敏hs-CRP,APN,ox-LDL和TNF-α;进行治疗前后血液流变学检测。结果:治疗后7 d,两组NIHSS评分均较治疗前下降(P<0.01),组间比较差异无统计学意义;治疗后14 d,两组NIHSS评分继续下降(P<0.01),观察组NIHSS评分低于对照组(P<0.01);两组治疗后血清hs-CRP,ox-LDL和TNF-α水平均较治疗前下降(P<0.01),观察组低于对照组(P<0.01);两组治疗后血清APN水平均较治疗前上升(P<0.01),观察组高于对照组(P<0.01);两组TC,TG和LDL-C水平均较治疗前明显下降(P<0.01),观察组TC和TG水平低于对照组(P<0.01);两组治疗后HDL-C水平较治疗前升高(P<0.01),组间比较差异无统计学意义;观察组全血黏度、血小板聚集率、血浆黏度及红细胞压积的改善优于对照组(P<0.01)。结论:疏血通注射液对急性脑梗死患者神经功能有改善作用,并能改善患者脂代谢,具有多靶点效应及抗炎、抗氧化、改善脑微循环等作用。 Objective: To investigate the effects of Shuxuetong injection on serum lipids in patients with acute cerebral infarction, serum hs-CRP, APN, ox-LDL, Effect of necrosis factor-α (TNF-α). Methods: 67 patients were randomly divided into control group (n = 22) and observation group (n = 45) before and after hospitalization. The control group was treated with conventional Western medicine, lipid-lowering atorvastatin calcium tablets, 10 mg / time, 1 time / d, taken after dinner. Observation group in the control group based on the treatment with Shuxuetong injection, 6 mL / time, intravenous drip, 1 / d, the two courses were 14 d. On the 0th, 7th and 14th day, the NIHSS scale was used to assess the severity of neurological deficits. The triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol C) and low density lipoprotein cholesterol (LDL-C) were measured. Hs-CRP, APN, ox-LDL and TNF-αwere detected by enzyme-linked immunosorbent assay. Results: On the 7th day after treatment, the NIHSS scores of both groups were significantly lower than those before treatment (P <0.01), and there was no significant difference between the two groups. On the 14th day after treatment, the NIHSS scores of both groups continued to decline (P <0.01) The NIHSS score was lower than that of the control group (P <0.01). The levels of serum hs-CRP, ox-LDL and TNF-α in the two groups after treatment were lower than those in the control group ). Serum APN levels in both groups were significantly higher than those before treatment (P <0.01), and were higher in the observation group than in the control group (P <0.01). The levels of TC, TG and LDL- (P <0.01). The levels of TC and TG in the observation group were lower than those in the control group (P <0.01). The levels of HDL-C in the two groups were significantly higher than those before treatment (P <0.01), and there was no significant difference between the two groups Whole blood viscosity, platelet aggregation, plasma viscosity and hematocrit improved better than the control group (P <0.01). Conclusion: Shuxuetong injection can improve neurological function in patients with acute cerebral infarction and improve lipid metabolism in patients with multi-target effect and anti-inflammatory, anti-oxidation, improve cerebral microcirculation and so on.
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