目的 探讨银丹心脑通软胶囊联合双联抗血小板药在急性脑梗死介入术后的临床效果。方法 选取2020年1月-2022年1月北京大学首钢医院收治的100例急性脑梗死患者,按随机数字表法分为对照组(50例)和治疗组(50例)。对照组口服阿司匹林肠溶片,100 mg/次,1次/d,同时口服硫酸氢氯吡格雷片,75 mg/次,1次/d。治疗组患者在对照组基础上口服银丹心脑通软胶囊,3粒/次,3次/d。两组患者均治疗2周。观察两组患者临床疗效,比较治疗前后两组患者美国国立卫生研究院卒中量表(NIHSS)和Barthel指数评分及过氧化脂质(LPO)、丙二醛(MDA)、miR-449a和miR-19b-3p水平。结果 治疗后,治疗组患者总有效率较对照组明显升高(96.00% vs 84.00%,P<0.05)。治疗后,两组患者NIHSS评分明显低于治疗前,而Barthel指数评分明显高于治疗前(P<0.05),且治疗组评分明显好于对照组(P<0.05)。治疗后,两组LPO和MDA水平及miR-19b-3p表达水平明显低于治疗前(P<0.05),而miR-449a表达水平明显高于治疗前(P<0.05),且治疗组患者这些指标水平明显好于对照组(P<0.05)。结论 银丹心脑通软胶囊联合双联抗血小板方案在急性脑梗死介入术后中具有较高疗效和安全性,有助于调节miR-449a、miR-19b-3p表达,减轻患者氧化应激水平,减轻神经功能缺损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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