胞二磷胆碱联合阿替普酶治疗急性脑梗死的疗效观察

Clinical observation on citicoline combined with alteplase in treatment of acute cerebral infarction

目的观察胞二磷胆碱联合阿替普酶治疗急性脑梗死的临床疗效。方法选取解放军第三一三医院2013年1月—2016年12月收治的110例急性脑梗死患者为研究对象,随机分为对照组和治疗组,每组各55例。对照组患者静脉泵入注射用阿替普酶,0.9 mg/kg,最大剂量为90 mg,1 min内静脉推注10%,然后60 min内匀速静脉泵入余下剂量。治疗组在对照组的基础上静脉滴注胞二磷胆碱注射液,0.75 g加入250 m L生理盐水,持续时间>40 min,1次/d。两组患者均连续治疗14 d。观察两组患者临床疗效,比较治疗前后两组患者美国国立卫生研究院卒中量表(NIHSS)和Barthel指数评定量表(BI)评分。结果治疗后,对照组和治疗组临床总有效率分别为74.55%、90.91%,两组比较差异具有统计学意义(P<0.05)。治疗7、14 d后,两组患者的NIHSS评分较治疗前明显降低,BI评分明显升高,同组治疗前后差异具有统计学意义(P<0.05);且治疗组NIHSS、BI评分明显优于同期对照组,两组比较差异具有统计学意义(P<0.05)。结论胞二磷胆碱联合阿替普酶治疗急性脑梗死疗效显著,可明显改善患者的神经功能和生存质量,具有一定的临床推广应用价值。

Objective To observe the clinical curative effect of citicoline combined with alteplase in treatment of acute cerebral infarction. Methods Patients（110 cases） with acute cerebral infarction in No. 313 Hospital of PLA from January 2013 to December 2016 were randomly divided into control and treatment groups, and each group had 55 cases. Patients in the control group were intravenous pumped with Alteplase for injection, 0.9 mg/kg, and the maximum dose was 90 mg. 10% of the dose was injected in 1 min, and then the other dose was intravenous pumped in 60 min with a constant speed. Patients in the treatment group were iv administered with Citicoline Injection, 0.75 g added into normal saline 250 m L, and duration time was more than 40 min, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the NIHSS and BI scores in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 74.55% and 90.91%, respectively, and there was difference between two groups（P〈0.05）. After treatment for 7 and 14 d, the NIHSS scores in two groups were significantly decreased, but the BI scores in two groups were significantly increased, and the difference was statistically significant in the same group（P〈0.05）. And the NIHSS and BI scores in the treatment group were significantly better than those in the control group, with significant difference between two groups（P〈0.05）. Conclusion Citicoline combined with alteplase has good effect in treatment of acute cerebral infarction, and can improve the nerve function and quality of life, which has a certain clinical application value.