奥拉西坦联合脉血康胶囊治疗急性脑梗死的疗效评价及对血清VCAM-1、ICAM-1、MMP-9水平的影响

Curative Efficacy of Oxiracetam Combined with Maixuekang Capsule in Treatment of Acute Cerebral Infarction and Its Effects on the Serum VCAM-1,ICAM-1 and MMP-9 Levels

目的:研究奥拉西坦联合脉血康胶囊治疗急性脑梗死的疗效及对血清血管细胞间黏附分子-1(VCAM-1)、细胞间粘附分子-1(ICAM-1)、基质金属蛋白酶-9(MMP-9)水平的影响。方法:选择2014年3月~2015年3月于我院就诊的急性脑梗死患者90例,按抽签法分为实验组和对照组,每组45例。两组均配合调脂、抗血小板、活血化瘀、维持电解质平衡、神经保护、降颅内压等常规治疗,必要时进行氧疗。对照组在此基础上加用奥拉西坦注射液治疗,每次4 g,加入250 mL生理盐水进行静脉滴注,每天1次。实验组在对照组基础上加用脉血康胶囊治疗,每次3粒,每天3次。两组治疗疗程均为3周。观察和比较两组的临床疗效,治疗前后NIHSS评分、血清VCAM-1、ICAM-1、MMP-9水平、MMSE、ADL评分的变化及不良反应的发生情况。结果:治疗后,实验组总有效率显著高于对照组(P<0.05);NIHSS评分显著低于对照组(P<0.05);血清VCAM-1、ICAM-1、MMP-9水平显著低于对照组(P<0.05);MMSE、ADL评分显著高于对照组(P<0.05);不良反应总发生率显著低于对照组(P<0.05)。结论:奥拉西坦联合脉血康胶囊治疗急性脑梗死能够有效提高其临床疗效,显著促进神经功能的恢复,可能与其有效降低血清VCAM-1、ICAM-1、MMP-9水平,改善血管内皮功能有关。

Objective： To study the curative efficacy of oxiracetam combined with maixuekang capsule in the treatment of acute cerebral infarction and its effects on the serum vascular cell adhesion molecule-1（VCAM-1）,cell adhesion molecule-1（ICAM-1）,Matrix metalloproteinase-9（MMP-9） levels. Methods： 90 patients with acute cerebral infarction who were treated from March 2014 to March2015 in our hospital were selected as the research objects. According to the draw method, those patients were divided into the experimental group（n=45） and the control group（n=45）. Both groups were treated with conventional therapy, such as lipid regulation, anti-platelet,blood circulation activation and removment of blood stasis, maintainance of electrolyte balance, nerve protection and reduction of intracranial pressure, oxygen therapy if necessary. The control group was treated with oxiracetam injection additionally, each time 4 G,added in 250 m L saline for intravenous drip, 1 times a day. While the observation group was treated with maixuekang capsule based on the control group, 3 tablets each time, 3 times a day. Two groups were treated for a period of 3 weeks. Then the clinical efficacy, changes of NIHSS score, serum VCAM-1, ICAM-1, MMP-9, MMSE, ADL score before and after treatment as well as the incidence of adverse reaction were compared between two groups. Results： The total effective rate of experimental group was significantly higher than that of the control group（P〈0.05）; the NIHSS score was significantly lower than that of the control group（P〈0.05）; the VCAM-1, ICAM-1,MMP-9 levels were significantly lower than those of the control group（P〈0.05）; the MMSE, ADL score were significantly higher than those of the control group（P〈0.05）; the incidence of adverse reactions was significantly lower than that of the control group（P〈0.05）.Conclusion： Oxiracetam combined with maixuekang capsule could enhance the efficacy of acute cerebral infarction, it could promote the recovery of nerve function, which might be related to regulate the levels of serum VCAM-1, ICAM-1 and MMP-9 levels and further improve the function of vascular endothelium.