马来酸桂哌齐特联合尤瑞克林治疗急性脑梗死临床研究

Clinical study on cinepazide maleate combined with urinary kallidinogenase in treatment of acute cerebral infarction

目的探讨马来酸桂哌齐特联合尤瑞克林治疗急性脑梗死的临床疗效。方法收集2015年10月—2016年10月在沈阳市第四人民医院治疗的急性脑梗死患者88例,根据治疗方案的不同分为对照组(44例)和治疗组(44例)。对照组患者静脉滴注注射用尤瑞克林30 min,0.15 PNA单位加入100 m L生理盐水中,1次/d。治疗组患者在对照组的基础上静脉滴注马来酸桂哌齐特注射液,8 m L加入10%葡萄糖注射液500 m L中,1次/d。两组患者均连续治疗2周。评价两组患者临床疗效,分析比较两组治疗前后ADL评分、神经功能缺损评分、血清学指标和血液流变学指标变化。结果治疗后,对照组和治疗组的总有效率分别为81.82%、97.73%,两组总有效率比较差异有统计学意义(P<0.05)。治疗后,两组ADL评分显著升高,神经功能缺损评分显著降低,同组比较差异具有统计学意义(P<0.05);且治疗组上述评分改善更显著(P<0.05)。治疗后,两组患者血清肿瘤坏死因子-α(TNF-α)、单核细胞趋化蛋白-1(MCP-1)、N末端B型脑钠肽原(NT-proBNP)和可溶性细胞间黏附分子-1(sICAM-1)水平均明显降低,而白细胞介素-10(IL-10)水平明显增高,同组比较差异具有统计学意义(P<0.05);且治疗组上述血清学指标改善程度优于对照组(P<0.05)。治疗后,两组患者纤维蛋白原、血浆黏度、全血低切黏度和全血高切黏度均显著降低(P<0.05);且治疗后治疗组患者比对照组降低更显著(P<0.05)。结论马来酸桂哌齐特联合尤瑞克林治疗急性脑梗死的临床效果显著,可明显改善患者神经功能和日常生活能力,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of cinepazide maleate combined with urinary kallidinogenase in treatment of acute cerebral infarction.Methods Patients （88 cases） with acute cerebral infarction in Shenyang the Fourth Hospital of People from October 2015 to October 2016 were divided into control （44 cases） and treatment （44 cases） groups based on different treatments. Patients in the control group were ivadministered with Urinary Kallidinogenase for injection for 30 min, 0.15 PNA added into 100 mL normal saline, once daily. Patients in the treatment group were ivadministered with Cinepazide Maleate Injection on the basis of the control group, 8 mL added into 10% glucose injection 500 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and ADL and neurological deficit scores, serological indexes, and blood rheology indexes in two groups before and after treatment were analyzed and compared.Results After treatment, the clinical efficacies in the control and treatment groups were 81.82% and 97.73%, respectively, and there was difference between two groups （P 〈 0.05）. After treatment, ADL score in two groups was significantly increased, while neurological deficit score was significantly decreased, and the difference was statistically significant in the same group （P 〈 0.05）. The two scores in the treatment were improved more significantly than those in the control group, with significant difference between two groups （P 〈 0.05）. After treatment, TNF-α, MCP-1, NT-proBNP, and sICAM-1 levels in two groups were significantly decreased, and IL-10 level was significantly increased, and there was difference in the same group （P 〈 0.05）. And these serological indexes in the treatment group were significantly better than those in the control group （P 〈 0.05）. After treatment, fibrinogen, plasma viscosity, whole blood low shear viscosity, and whole blood high shear viscosity in two groups were significantly decreased （P 〈 0.05）. And these blood rheology indexes in the treatment group were significantly lower than those in the control group （P 〈 0.05）.Conclusion Cinepazide maleate combined with urinary kallidinogenase has a significant effect in treatment of acute cerebral infarction, and can significantly improve the neurological function and activity of daily living, which has a certain clinical application value.