马来酸桂哌齐特对急性脑梗死患者炎症因子及神经功能缺损程度的影响

Effects of cinepazide maleate on inflammatory factors and neural functional defects in patients with acute cerebral infarction

目的探讨马来酸桂哌齐特(CM)对急性脑梗死(ACI)患者炎症因子及神经功能缺损程度的影响。方法选择急性脑梗死患者80例,采用随机数字表法将其分为两组,每组40例。对照组给予常规治疗(脱水、抗凝、护脑、高压氧及对症治疗),观察组在对照组治疗基础上给予马来酸桂哌齐特治疗,疗程14 d。监测两组治疗前后白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、可溶性细胞间黏附分子-1(s ICAM-1)、基质金属蛋白酶-9(MMP-9)水平、梗塞体积及美国国立卫生研究院卒中量表(NIHSS)评分,并评定临床疗效。结果治疗14 d后,观察组基本痊愈19例,显著进步14例,进步6例,无效1例;对照组依次为10、12、10、8例,观察组疗效优于对照组(P<0.05)。治疗前两组患者的IL-6、TNF-α、s ICAM-1、MMP-9水平、梗塞体积及NIHSS评分比较差异无统计学意义(P均>0.05),具有可比性。治疗14 d后两组患者的上述指标均较治疗前显著改善(P均<0.01),观察组较对照组改善更显著(P均<0.01)。观察组不良反应发生率为15%,与对照组的10%比较差异无统计学意义(χ2=0.4571,P>0.05)。结论 CM治疗急性脑梗死安全有效,能缩小梗死面积,改善预后,降低炎症因子(IL-6、TNF-α、s ICAM-1、MMP-9)水平可能为其作用机制之一。

Objective To study the effects of cinepazide maleate on inflammatory factors and neural func- tional defects in patients with acute cerebral infarction（ACI）. Methods Eighty patients with ACI were randomly divided into two groups, with 40 cases in each group. The control group （n = 40） was given routine treatment（ dehydration, anticoagulation, protecting brain, hyperbaric oxygen and symptomatic treatment） and the obseryation group （ n = 40） was given cinepazide maleate based on the same＇treatment in the control group. Both of the two groups were treated for 14 days. The levels of IL-6, TNF-α, sICAM-1, MMP-9, infarct volume and NIHSS score were detected in each group before and after treatment and their clinical efficacy were evaluated. Results After 14 days of the treat- ment, the efficacy was excellent in 19 cases, good in 14 cases, improved in 6 cases in the observation group, and in- valid in 1 case; the efficacy counterparts in the control group were 10, 12, 10 and 8 respectively. The effect of the observation group was better than that of the control group（P 〈 0.05）. There were no significant differences between the two groups in the levels of IL-6, TNF-α, sICAM-1, MMP-9, infarct volume and national institute health stroke scale（NIHSS） score before the treatment（P 〉 0. 05 ）. After 14 days of the treatment, the above indicators in the two groups were significantly improved than those before the treatment（ P 〈 0.01 ） , however the indicators were improved more obviously in the observation group（P 〈 0. 01 ） ; There was no significant difference in the incidence of adverse reactions between the observation group（ 15% ） and the control group（ 10 % ） （X2 = 0. 4571, P 〉 0. 05）. Conclusion Cinepazide maleate is safe and effective in the treatment of acute cerebral infarction. It can reduce infarction area, improve prognosis and reduce the levels of iidlammatory factors （IL-6, TNF-α, sICAM-1, MMP-9）, which may be one of the mechanisms of action.