目的 探討銀丹心腦通軟膠囊聯(lián)合雙聯(lián)抗血小板藥在急性腦梗死介入術(shù)后的臨床效果。方法 選取2020年1月-2022年1月北京大學(xué)首鋼醫(yī)院收治的100例急性腦梗死患者,按隨機(jī)數(shù)字表法分為對(duì)照組(50例)和治療組(50例)。對(duì)照組口服阿司匹林腸溶片,100 mg/次,1次/d,同時(shí)口服硫酸氫氯吡格雷片,75 mg/次,1次/d。治療組患者在對(duì)照組基礎(chǔ)上口服銀丹心腦通軟膠囊,3粒/次,3次/d。兩組患者均治療2周。觀察兩組患者臨床療效,比較治療前后兩組患者美國(guó)國(guó)立衛(wèi)生研究院卒中量表(NIHSS)和Barthel指數(shù)評(píng)分及過氧化脂質(zhì)(LPO)、丙二醛(MDA)、miR-449a和miR-19b-3p水平。結(jié)果 治療后,治療組患者總有效率較對(duì)照組明顯升高(96.00% vs 84.00%,P<0.05)。治療后,兩組患者NIHSS評(píng)分明顯低于治療前,而Barthel指數(shù)評(píng)分明顯高于治療前(P<0.05),且治療組評(píng)分明顯好于對(duì)照組(P<0.05)。治療后,兩組LPO和MDA水平及miR-19b-3p表達(dá)水平明顯低于治療前(P<0.05),而miR-449a表達(dá)水平明顯高于治療前(P<0.05),且治療組患者這些指標(biāo)水平明顯好于對(duì)照組(P<0.05)。結(jié)論 銀丹心腦通軟膠囊聯(lián)合雙聯(lián)抗血小板方案在急性腦梗死介入術(shù)后中具有較高療效和安全性,有助于調(diào)節(jié)miR-449a、miR-19b-3p表達(dá),減輕患者氧化應(yīng)激水平,減輕神經(jīng)功能缺損及提高日常生活能力。

Objective To explore the clinical effect of Yindan Xinnaotong Soft Capsules combined with duplex antiplatelet regimen in treatment of acute cerebral infarction. Methods Patients (100 cases) with acute cerebral infarction in Peking University Shougang Hospital from January 2020 to January 2022 were divided into control (50 cases) and treatment (50 cases) group according to random number table method. Patients in the control group were po administered with Aspirin Enteric-coated Tablets, 100 mg/time, once daily, and they were po administered with Clopidogrel Hydrogen Sulphate Tablets, 75 mg/time, once daily. Patients in the treatment group were po administered with Yindan Xinnaotong Soft Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical evaluations were evaluated, the scores of NIHSS and Barthel index, and the levels of LPO, MDA, miR-449a and miR-19b-3p in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was significantly higher than that of the control group (96.00% vs 84.00%, P < 0.05). After treatment, the NIHSS score in two groups was significantly lower than that before treatment, while the score of Barthel index was significantly higher (P < 0.05), and which in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the levels of LPO and MDA and the expression of miR-19b-3p in two groups were significantly lower than those before treatment (P < 0.05), while the expression level of miR-449a in the treatment group was significantly higher(P < 0.05), and the level of these indexes in the treatment group was significantly better than that in the control group (P < 0.05). Conclusion Yindan Xinnaotong Soft Capsules combined with duplex antiplatelet regimen has high efficacy and safety in patients with acute cerebral infarction after interventional operation, which is helpful to regulate the expression of miR-449a and miR-19b-3p, reduce the level of oxidative stress and neurological impairment, and improve the ability of daily living.

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