目的 分析丁苯酞软胶囊对中重度脑白质疏松患者认知功能、血清血管内皮生长因子（VEGF）、血管生成素-2（Ang-2）、S100β、神经元特异性烯醇化酶（NSE）水平的影响。方法 选取2019年9月—2020年9月沧州市中心医院收治的中重度脑白质疏松患者98例作为研究对象，按治疗方法将患者分为对照组和观察组，每组各49例。对照组患者给予常规治疗，包括常规监测血压、血糖等相关危险因素，给予对症处理。观察组在对照组治疗的基础上口服丁苯酞软胶囊，2粒/次，3次/d，两组共治疗12周。比较两组Van Swieten量表分级情况，认知功能，血清VEGF、Ang-2、S100β、NSE水平，大脑中动脉血流速度和PI值。结果 治疗后两组Van Swieten量表分级情况均优于治疗前（P<0.05），且观察组Van Swieten量表分级情况优于对照组（P<0.05）。治疗后，两组血清VEGF、Ang-2水平均高于治疗前，S100β、NSE水平均低于治疗前（P<0.05）；且观察组血清VEGF、Ang-2水平均高于对照组，S100β、NSE水平均低于对照组（P<0.05）。治疗后，两组MMSE评分、MoCA评分均高于治疗前（P<0.05），且观察组MMSE评分、MoCA评分高于对照组（P<0.05）。治疗后，两组收缩期峰血流速度（V_s）、平均血流速度（V_m）均高于治疗前，PI均低于治疗前（P<0.05）；且观察组V_s、V_m高于对照组，PI低于对照组（P<0.05）。结论 丁苯酞软胶囊能减缓或逆转中重度脑白质疏松，改善患者认知功能、脑血流情况，调节血清VEGF、Ang-2、S100β、NSE水平，值得临床应用推广。

Objective To analyze the effects of Butylphthalide Soft Capsules on cognitive function, serum VEGF, Ang-2, S100β, NSE levels in patients with moderate and severe leukoencephalopathy. Methods A total of 98 patients with moderate to severe leukmatter osteoporosis admitted to Cangzhou Central Hospital from September 2019 to September 2020 were selected as the research subjects. According to the treatment methods, the patients were divided into control group and observation group, with 49 patients in each group. Patients in the control group were given routine treatment, including routine monitoring of blood pressure, blood glucose and other risk factors, and given symptomatic treatment. Patients in the observation group were additively treated with Butylphthalide Soft Capsules, 2 pills/time, 3 times daily. The two groups were treated for 12 weeks. The classification of Van Swieten scale, cognitive function, serum levels of VEGF, Ang-2, S100β, NSE, blood flow velocity of middle cerebral artery, and PI were compared between two groups.Results After treatment, the classification of Van Swieten scale in two groups was better than that before treatment (P < 0.05), and the classification of Van Swieten scale in the observation group was better than that in the control group (P < 0.05). After treatment, the levels of serum VEGF and Ang-2 were higher than before treatment, but the levels of S100β and NSE were lower than before treatment (P < 0.05). The levels of serum VEGF and Ang-2 in observation group were higher than those in control group, and the levels of S100β and NSE in observation group were lower than those in control group (P < 0.05). After treatment, MMSE and MOCA scores in two groups were higher than those before treatment (P < 0.05), and MMSE and MOCA scores in observation group were higher than those in control group (P < 0.05). After treatment, V_s and V_m in both groups were higher than before, and PI was lower than before (P < 0.05). V_s and V_m in observation group were higher than those in control group, and PI in observation group was lower than that in control group (P < 0.05). Conclusion Butylphthalide Soft Capsules can slow down or reverse moderate to severe cerebral white matter osteoporosis, improve cognitive function, cerebral blood flow, regulate serum VEGF, Ang-2, S100β, NSE levels, worthy of clinical application and promotion.

R971

沧州市重点研发计划指导项目（172302020）