CAJ | 학술논문

目的探讨丁苯酞对重度颈内动脉颅内段狭窄患者脑血管反应性(cerebrovascular reactivity,CVR)的影响.方法将2010年1月至2010年11月期间南京卒中注册系统中经脑血管造影确诊为颈内动脉颅内段重度狭窄的患者,随机分为丁苯酞组和对照组.所有患者均给予符合指南规定的缺血性脑血管病治疗药物,丁苯酞组加用丁苯酞(20 mg,3次/d).所有患者均在治疗前采用经颅多普勒和CO2吸入激发试验评价患者CVR,并在治疗后3个月复查.结果 81例患者符合纳入标准,失访11例(13.6％),最终有70例纳入分析,丁苯酞组和对照组各35例.患者平均年龄(55.2±9.0)岁,男性47例,女性23例,血管狭窄程度为72％～ 99％,平均79.4％±9.5％.治疗3个月后,丁苯酞组CVR显著改善(P=0.007),而对照组改善不显著(P =0.330).服药期间所有患者均未发生缺血性卒中事件,丁苯酞组未发生严重不良反应.结论丁苯酞可改善重度颈内动脉颅内段狭窄患者的CVR.
목적 탐토정분태대중도경내동맥로내단협착환자뇌혈관반응성(cerebrovascular reactivity,CVR)적영향.방법 장2010년1월지2010년11월기간남경졸중주책계통중경뇌혈관조영학진위경내동맥로내단중도협착적환자,수궤분위정분태조화대조조.소유환자균급여부합지남규정적결혈성뇌혈관병치료약물,정분태조가용정분태(20 mg,3차/d).소유환자균재치료전채용경로다보륵화CO2흡입격발시험평개환자CVR,병재치료후3개월복사.결과 81례환자부합납입표준,실방11례(13.6％),최종유70례납입분석,정분태조화대조조각35례.환자평균년령(55.2±9.0)세,남성47례,녀성23례,혈관협착정도위72％～ 99％,평균79.4％±9.5％.치료3개월후,정분태조CVR현저개선(P=0.007),이대조조개선불현저(P =0.330).복약기간소유환자균미발생결혈성졸중사건,정분태조미발생엄중불량반응.결론 정분태가개선중도경내동맥로내단협착환자적CVR.
Objective To investigate the effect of butylphthalide on cerebrovascular reactivity (CVR) in patients with severe intracranial internal carotid stenosis.Methods The patients with severe intracranial internal carotid stenosis diagnosed by cerebral angiography in Nanjing Stroke Registry Program from January 2010 to November 2010 were randomly divided into either the butylphthalide group or the control group.All patients received the oral drugs for ischemic cerebrovascular disease that met the guideline criteria,and butylphthalide 20 mg,3 times a day orally was added in the butylphthalide group.The CVR was evaluated by transcranial Doppler and CO2 inhalation challenge test,and reexamined 3 months after treatment.Results A total of 81 patients met the inclusion criteria,11 (13.6％) were lost to follow-up,and finally 70 (n =35 in each group) were included in the analysis.The mean age of the patients was 55.2 ± 9.0 years,47 of them were male and 23 were female.The degree of vascular stenosis was 72％ to 99％ (mean 79.4％ ± 9.5％).The CVR was improved significantly after 3 months of treatment in the butylphthalide group than that in the control group (P =0.007),but it was not improvedsignificantly in the control group (P =0.330).All the patients did not have ischemic stroke events during the medication.No serious adverse reactions occurred in the butylphthalide group.Conclusions Butylphthalide may improve the CVR in patients with severe intracranial internal carotid stenosis.