丁苯酞對腦小血管病患者血管內皮功能及認知功能的影響

陸冰

【摘要】 目的：研究丁苯酞對腦小血管病（CSVD）患者血管內皮功能及認知功能的影響。方法：納入符合CSVD診斷并按計劃完成的腦小血管病患者，將患者隨機分為對照組和試驗組。對照組（46例）采用常規治療，試驗組（42例）在常規治療基礎上加服丁苯酞膠囊。流式細胞儀檢測外周血EPCs數目；ELISA檢測血清ICAM-1、ET-1水平；MoCA量表評估認知功能；Barthel指數評估日常生活活動能力，比較兩組患者以上指標的變化情況。結果：治療前，兩組EPCs數目、ICAM-1及ET-1水平比較，差異均無統計學意義（P>0.05）。治療12周時，試驗組EPCs數目高于對照組及治療前，差異均有統計學意義（P<0.05）；試驗組ICAM-1及ET-1水平均低于對照組及治療前，差異均有統計學意義（P<0.05）。治療12周時，試驗組MoCA評分及Barthel指數均高于對照組及治療前，差異均有統計學意義（P<0.05）。試驗組治療12周時的MoCA評分與EPCs、ICAM-1及ET-1的變化幅度均呈正相關（P<0.05）。結論：丁苯酞能改善CSVD患者血管內皮功能和認知功能，可能與增加外周血EPCs數目、有效調控血清ICAM-1及ET-1表達有關。

【關鍵詞】 丁苯酞； 腦小血管病； 內皮祖細胞； 細胞間黏附分子-1； 內皮素-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