[关键词]
[摘要]
目的 探讨血塞通注射液联合脑苷肌肽注射液治疗老年急性脑梗死的临床效果。方法 选取2015年1月-2017年12月海南西部中心医院收治的老年急性脑梗死患者180例,随机分成对照组(90例)和治疗组(90例)。对照组静脉滴注脑苷肌肽注射液,20 mL加入300 mL生理盐水,1次/d。治疗组在对照组的基础上静脉滴注血塞通注射液,400 mg加入250 mL生理盐水,1次/d。两组连续治疗14 d。观察两组患者临床疗效,同时比较治疗前后两组患者美国国立卫生研究院卒中量表(NIHSS)评分、脑卒中专门化生存质量量表(SS-QOL)评分、理化指标、大脑中动脉(MCA)血流动力学参数、同型半胱氨酸(Hcy)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、丙二醛(MDA)和超氧化物歧化酶(SOD)水平。结果 治疗后,对照组的总有效率为76.7%,显著低于治疗组的91.1%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者NIHSS评分显著下降,SS-QOL评分显著升高,同组治疗前后比较差异具有统计学意义(P<0.05),且治疗后治疗组NIHSS和SS-QOL评分明显优于对照组(P<0.05)。治疗后,两组患者血清总胆固醇(TC)/高密度脂蛋白胆固醇(HDL-C)比值、血浆黏度(PV)和红细胞聚集指数(EAI)值比治疗前显著降低,血小板计数(PLT)值显著升高,同组治疗前后比较差异具有统计学意义(P<0.05),且治疗后治疗组上述理化指标改善水平明显优于对照组(P<0.05)。治疗后,两组患者血流动力学参数收缩期峰值血流速度(Vs)和舒张末期血流速度(Vd)均显著升高(P<0.05),且治疗后治疗组Vs和Vd明显高于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者血清Hcy、TNF-α、IL-6和MDA浓度较治疗前均显著降低,SOD水平显著升高,同组治疗前后比较差异具有统计学意义(P<0.05),且治疗后治疗组Hcy、TNF-α、IL-6、MDA和SOD水平明显优于对照组(P<0.05)。结论 血塞通注射液联合脑苷肌肽治疗老年急性脑梗死疗效显著,能明显改善微循环,增加局部脑血流量,减轻炎症损伤。
[Key word]
[Abstract]
Objective To investigate the clinical effect of Xuesaitong Injection combined with Cattle Encephalon Glycoside and Ignotin Injection in treatment of elderly patients with acute cerebral infarction. Methods Patients (180 cases) with acute cerebral infarction in Hainan West Central Hospital from January 2015 to December 2017 were randomly divided into control (90 cases) and treatment (90 cases) groups. Patients in the control group were iv administered with Cattle Encephalon Glycoside and Ignotin Injection, 20 mL added into 300 mL normal saline, once daily. Patients in the treatment group were iv administered with Xuesaitong Injection on the basis of the control group, 400 mg added into 250 mL normal saline, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the NIHSS scores, SS-QOL scores, the physical and chemical indexes, and MCA, Hcy, TNF-α, IL-6, MDA and SOD levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 76.7%, which was significantly lower than 91.1% in the treatment group, and there were differences between two groups (P < 0.05). After treatment, the NIHSS scores in two groups were significantly decreased, but SS-QOL scores were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the NIHSS and SS-QOL scores in the treatment group after treatment were significantly better than those in the control group (P < 0.05). After treatment, the TC/HDL-C, PV and EAI in two groups were significantly decreased (P < 0.05), but PLT levels were significantly increased (P < 0.05), and these physical and chemical indexes in the treatment group after treatment were significantly better than those in the control group (P < 0.05). After treatment, the Vs and Vd in two groups were significantly increased (P < 0.05), and the Vs and Vd in the treatment group after treatment were significantly higher than those in the control group (P < 0.05). After treatment, the Hcy, TNF-α, IL-6 and MDA levels in two groups were significantly decreased (P < 0.05), but SOD levels were significantly increased (P < 0.05), and these indexes in the treatment group after treatment were significantly better than those in the control group (P < 0.05). Conclusion Xuesaitong Injection combined with Cattle Encephalon Glycoside and Ignotin Injection has obvious curative effect in treatment of elderly patients with acute cerebral infarction, and can significantly improve microcirculation, increase local cerebral blood flow, and reduce inflammatory injury.
[中图分类号]
[基金项目]