丁苯酞對(duì)腦小血管病患者血管內(nèi)皮功能及認(rèn)知功能的影響

陸冰

【摘要】 目的：研究丁苯酞對(duì)腦小血管病（CSVD）患者血管內(nèi)皮功能及認(rèn)知功能的影響。方法：納入符合CSVD診斷并按計(jì)劃完成的腦小血管病患者，將患者隨機(jī)分為對(duì)照組和試驗(yàn)組。對(duì)照組（46例）采用常規(guī)治療，試驗(yàn)組（42例）在常規(guī)治療基礎(chǔ)上加服丁苯酞膠囊。流式細(xì)胞儀檢測外周血EPCs數(shù)目；ELISA檢測血清ICAM-1、ET-1水平；MoCA量表評(píng)估認(rèn)知功能；Barthel指數(shù)評(píng)估日常生活活動(dòng)能力，比較兩組患者以上指標(biāo)的變化情況。結(jié)果：治療前，兩組EPCs數(shù)目、ICAM-1及ET-1水平比較，差異均無統(tǒng)計(jì)學(xué)意義（P>0.05）。治療12周時(shí)，試驗(yàn)組EPCs數(shù)目高于對(duì)照組及治療前，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）；試驗(yàn)組ICAM-1及ET-1水平均低于對(duì)照組及治療前，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療12周時(shí)，試驗(yàn)組MoCA評(píng)分及Barthel指數(shù)均高于對(duì)照組及治療前，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。試驗(yàn)組治療12周時(shí)的MoCA評(píng)分與EPCs、ICAM-1及ET-1的變化幅度均呈正相關(guān)（P<0.05）。結(jié)論：丁苯酞能改善CSVD患者血管內(nèi)皮功能和認(rèn)知功能，可能與增加外周血EPCs數(shù)目、有效調(diào)控血清ICAM-1及ET-1表達(dá)有關(guān)。

【關(guān)鍵詞】 丁苯酞； 腦小血管病； 內(nèi)皮祖細(xì)胞； 細(xì)胞間黏附分子-1； 內(nèi)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-1endprint