奥拉西坦配合常规疗法治疗急性脑梗死患者的疗效及对认知功能的影响

Effect of oxiracetam combined with conventional therapy on patients with acute cerebral infarction and its effect on cognitive function

目的探讨脑代谢激活剂配合常规疗法对急性脑梗死(ACI)患者的治疗效果。方法选取2016年4月至2018年4月收治的ACI患者78例为研究对象,以随机数字表法分为对照组39例,观察组39例,对照组给予静脉溶栓、降颅内压、抗血小板聚集、扩张血管等常规治疗,观察组在对照组基础上加用脑代谢激活剂奥拉西坦,观察两组治疗效果,治疗前、治疗2w后神经功能、认知功能变化及用药期间不良反应发生情况。结果观察组治疗总有效率为94.87%,同对照组81.58%对比,差异有统计学意义(P<0.05);治疗前两组神经功能缺损程度及认知功能差异无统计学意义(P>0.05),治疗后均有改善,观察组治疗2w后日常生活能力量表(ADL)、斯堪的纳维亚卒中量表(SSS)评分与同期对照组对比,明显较低,简易智力状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)与同期对照组对比,明显较高,差异有统计学意义(P<0.05);观察组用药期间不良反应发生率为20.51%,同对照组15.38%对比,差异无统计学意义(P>0.05)。结论脑代谢激活剂配合常规疗法治疗ACI,可显著增强疗效,减少神经功能缺损,改善认知功能,且安全性高,有临床应用价值。

Objective To explore the therapeutic effect of cerebral metabolic activator combined with conventional therapy on acute cerebral infarction(ACI). Method 78 patients with ACI admitted in Apr 2016 to Apr 2018 were selected as the study subjects, the random digital table was divided into 39 patients in the control group and 39 patients in the observation group. The control group received conventional therap including intravenous thrombolysis, intracranial pressure reduction, antiplatelet aggregation, and dilation of blood vessels, the observation group added cerebral metabolic activator oxiracetam on the basis of the control group. The therapeutic effects, the changes of neurological function and cognitive function before and 2 weeks after treatment and the adverse reactions during medication of the two groups were observed. Results The total effective rate of the observation group was 94.87%, compared with the control group(81.58%), the difference was statistically significant(P<0.05);There was no significant difference in the degree of nerve function defect and cognitive function between the two groups before treatment(P>0.05), all improved after treatment. After 2 weeks of treatment, the activity of daily living scale(ADL) and Scandinavia Stroke Scale(SSS) were compared with those in the control group, which was significantly lower, the mini-mental state examination scale(MMSE) and montreal cognitive assessment scale(MoCA) was significantly higher than that of the control group, the difference was statistically significant(P<0.05);the adverse reactions during medication in the observation group was 20.51%, compared with the control group(15.38%), the difference was not statistically significant(P>0.05). Conclusion Cerebral metabolic activator combined with conventional therapy in the treatment of ACI can significantly improve the curative effect, reduce the nerve function defect, improve the cognitive function, and have high safety, have clinical application value.