尤瑞克林联合依达拉奉治疗急性脑梗死疗效观察

Effect of urinary kallidinogenase combined with edaravone in the treatment of acute cerebral infarction

目的探讨尤瑞克林和依达拉奉联合治疗急性脑梗死(ACI)的临床效果。方法选择河南省荣军医院2016年3月至2017年12月收治的75例ACI患者为研究对象,根据治疗方法将患者分为观察组(n=35)和对照组(n=40)。2组患者均给予常规治疗,在此基础上,对照组患者给予依达拉奉治疗,观察组患者给予依达拉奉和尤瑞克林联合治疗,治疗14 d。2组患者分别于治疗前及治疗后采用美国国立卫生研究院卒中量表(NIHSS)进行神经功能缺损评分,采用Barthel指数评定患者日常生活活动能力(ADL),并评定临床疗效;分别于治疗前及治疗后采用酶联免疫吸附试验检测血清丙二醛(MDA)、超氧化物歧化酶(SOD)、氧化型低密度脂蛋白(ox-LDL)、基质金属蛋白酶-9(MMP-9)、神经元特异性烯醇化酶(NSE)和脑源性神经营养因子(BDNF)水平。结果治疗前2组患者血清MDA、SOD、ox-LDL、MMP-9、NSE及BDNF水平比较差异无统计学意义(P> 0. 05);与治疗前比较,治疗后2组患者血清MDA、ox-LDL、MMP-9及NSE水平显著降低,SOD和BDNF水平显著升高(P <0. 05);治疗后,观察组患者血清MDA、ox-LDL、MMP-9及NSE水平显著低于对照组,SOD和BDNF水平显著高于对照组(P <0. 05)。治疗前2组患者NIHSS、ADL评分比较差异均无统计学意义(P> 0. 05);与治疗前比较,治疗后2组患者NIHSS评分显著降低,ADL评分显著升高(P <0. 05);治疗后,观察组患者NIHSS评分显著低于对照组,ADL评分显著高于对照组(P <0. 05)。观察组和对照组患者治疗总有效率分别为91. 43%(32/35)、72. 50%(29/40),观察组患者总有效率高于对照组(χ~2=11. 362,P <0. 05)。结论尤瑞克林联合依达拉奉治疗ACI可以有效清除自由基,抑制脂质过氧化反应,改善脑组织血液供应,促进神经功能恢复,提高患者生活质量。

Objective To investigate the clinical effect of urinary kallidinogenase combined with edaravone in the treatment of acute cerebral infarction (ACI).Methods A total of 75 patients with ACI in Henan Rongjun Hospital from March 2016 to December 2017 were selected as the subjects.The patients were divided into observation group (n=35) and control group (n=40) according to the treatment method.All patients were given conventional treatment,based on this,the patients in the control group were treated with edaravone,while the patients in the observation group were treated with edaravone and urinary kallidinogenase for 14 days.The neurological deficit score of the patients in the two groups was assessed by national institutes of health stroke scale(NIHSS),the activity of daily living (ADL) of the patients was evaluated by Barthel index before and after treatment.The clinical efficacy was evaluated.The levels of serum malondialdehyde (MDA),superoxide dismutase (SOD),oxidized low density lipoprotein (ox-LDL),matrix metalloproteinase-9 (MMP-9),neuron-specific enolase (NSE) and brain-derived neurotrophic factor (BDNF) were detected by enzyme-linked immunosorbent assay before and after treatment.Results There was no significant difference in the levels of serum MDA,SOD,ox-LDL,MMP-9,NSE and BDNF between the two groups before treatment (P>0.05).Compared with before treatment,the levels of serum MDA,ox-LDL,MMP-9 and NSE in the two groups decreased significantly,while the levels of serum SOD and BDNF increased significantly (P<0.05).The levels of serum MDA,ox-LDL,MMP-9 and NSE in the observation group were significantly lower than those in the control group;and the levels of SOD and BDNF were significantly higher than those in the control group after treatment (P<0.05).There was no significant difference in the NIHSS score and ADL score between the two groups before treatment (P>0.05).Compared with before treatment,the NIHSS score was decreased significantly,and the ADL score was increased significantly after treatment in the two groups (P<0.05).The NIHSS score in the observation group was significantly lower than that in the control group,and the ADL score in the observation group was significantly higher than that in the control group after treatment (P<0.05).The total effective rate in the observation group and the control group was 91.43%(32/35) and 72.50%(29/40),respectively.The total effective rate in the observation group was higher than that in the control group (χ^2=11.362,P<0.05).Conclusion Urinary kallidinogenase combined with edaravone in the treatment of ACI can effectively scavenge free radicals,inhibit lipid peroxidation,improve the blood supply of brain tissues,promote the recovery of nerve function and improve the quality of life of the patients.