尤瑞克林对急性脑梗死后血管再生、单核细胞趋化蛋白-1及认知功能影响研究

Effects of urinarykallid on angiogenesis,monocyte chemoattractant protein-1 and cognitive function in patients with acute cerebral infarction

目的:探讨尤瑞克林对急性脑梗死(ACI)后血管再生、单核细胞趋化蛋白-1(MCP-1)及认知功能的影响。方法:将2015年3月至2017年3月陕西省人民医院收治95例ACI患者随机分为观察组(48例)和对照组(47例)。对照组给予常规治疗,观察组在对照组的基础上联合尤瑞克林治疗。比较两组临床疗效、治疗前及治疗28 d、治疗3个月后的美国国立卫生院卒中量表(NIHSS)评分、蒙特利尔认知评估量表(MoCA)评分及血清MCP-1、血管内皮生长因子(VEGF)、血管生成素(ANG)水平。结果:观察组的治疗总有效率显著高于对照组(P<0.05);治疗后3个月,观察组认知功能障碍发生率显著低于对照组(P<0.05);治疗28 d、3个月后,观察组的NIHSS评分显著低于对照组(P<0.05),MoCA评分显著高于对照组(P<0.05);治疗28 d、3个月后,观察组的血清MCP-1水平显著低于对照组(P<0.05),而VEGF和ANG水平均显著高于对照组(P<0.05)。结论:尤瑞克林可显著改善ACI患者的认知功能和神经功能,可能机制为通过上调血清MCP-1、VEGF、ANG等而发挥抗炎、促血管再生作用。

Objective： To investigate the effect of urinarykallid on angiogenesis,monocyte chemoattractant protein-1（MCP-1）and cognitive function in patients with acute cerebral infarction（ACI）. Methods： A total of 102 patients with ACI were randomly divided into two groups： the control group（n=48）in which the patients received conventional treatment,and the observation group（n=47）in which the patients were treated as the controls with addition of urinarykallid. The clinical efficacy,the National Institutes of Health Stroke Scale（NIHSS）score and Montreal Cognitive Assessment（MoCA）scores as well as the serum levels of MCP-1,vascular endothelial growth factor（VEGF）and angiopoietin（ANG）were compared. Results： The total effective rate in the observation group was significantly higher than that in the control group（P〈0. 05）. At 3 months after treatment,the incidence of cognitive dysfunction in the observation group was significantly lower than that in the control group（P〈0. 05）. At 28 days and 3 months after treatment,the NIHSS score in the observation group was significantly lower than that in the control group,while the MoCA score was significantly higher（P〈0. 05）.The MCP-1 level in the observation group was significantly lower than that in the control group,while the levels of VEGF and ANG were markedly higher（P〈0. 05）. Conclusion： Urinarykallid could effectively improve the cognitive function and neurological function in ACI patients,and its mechanisms might by means of up-regulating MCP-1,VEGF and ANG levels.