依达拉奉注射液联合参麦注射液治疗老年缺血性脑卒中患者的临床疗效及其对血清内脏脂肪特异性丝氨酸蛋白酶抑制因子、抵抗素水平和脑血流动力学的影响

Clinical Effect of Edaravone Injection Combined with Shenmai Injection in Treating Elderly Patients with Ischemic Stroke and the Impact on Serum Levels of Vaspin and Resistin,and Cerebral Hemodynamics

目的观察依达拉奉注射液联合参麦注射液治疗老年缺血性脑卒中患者的临床疗效,并探讨其对血清内脏脂肪特异性丝氨酸蛋白酶抑制因子(Vaspin)、抵抗素(Resistin)水平和脑血流动力学的影响。方法选取2016年1月-2019年1月自贡市第四人民医院收治的老年缺血性脑卒中患者140例,采用随机数字表法分为对照组和观察组,每组70例。两组患者入院后均予以常规治疗,对照组患者给予依达拉奉注射液治疗,观察组患者在对照组基础上给予参麦注射液治疗;两组患者均持续治疗2周。比较两组患者临床疗效及治疗前后血清Vaspin、Resistin、脑血流动力学指标[包括双侧大脑中动脉峰流速(Vp)、双侧大脑中动脉平均流速(Vm)及其对称性差值(DVp、DVm)]、美国国立卫生研究院卒中量表(NIHSS)评分,记录两组患者治疗期间不良反应发生情况。结果(1)观察组患者临床疗效优于对照组(P<0.05)。(2)两组患者治疗前血清Vaspin、Resistin水平比较,差异无统计学意义(P>0.05);与对照组相比,观察组患者治疗后血清Vaspin水平升高,血清Resistin水平降低(P<0.01)。(3)两组患者治疗前Vp、Vm、DVp、DVm比较,差异无统计学意义(P>0.05);与对照组相比,观察组患者治疗后Vp、Vm加快,DVp、DVm减小(P<0.01)。(4)两组患者治疗前NIHSS评分比较,差异无统计学意义(P>0.05);与对照组相比,观察组患者治疗后NIHSS评分降低(P<0.01)。(5)两组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论依达拉奉注射液联合参麦注射液治疗老年缺血性脑卒中患者的临床疗效确切,可有效提高血清Vaspin水平,降低血清Resistin水平,改善脑血流动力学,促进神经功能恢复,且安全性较高。

Objective To observe the clinical effect of edaravone injection combined with shenmai injection in treating elderly patients with ischemic stroke,to investigate the impact on serum levels of Vaspin and Resistin,and cerebral hemodynamics.Methods From January 2016 to January 2019,a total of 140 elderly patients with ischemic stroke were selected in the Fourth People’s Hospital of Zigong,and they were divided into control group and observation group by random number table method,with 70 cases in each group.Based on routine treatment,patients in control group were treated with edaravone injection,while patients in observation group were treated with shenmai injection based on that of control group;both groups were continuously treated for 2 weeks.Clinical effect,serum levels of Vaspin and Resistin,cerebral hemodynamic index(including Vp,Vm,DVp,DVm)and NIHSS score before and after treatment were compared between the two groups,and incidence of adverse reactions was recorded during treatment.Results(1)Clinical effect in observation group was statistically significantly better than that in control group(P<0.05).(2)Compared with those in control group,observation group showed similar serum levels of Vaspin and Resistin before treatment(P>0.05),higher serum Vaspin level but lower serum Resistin level after treatment(P<0.01).(3)Compared with those in control group,observation group showed similar Vp,Vm,DVp and DVm before treatment(P>0.05),faster Vp and Vm,smaller DVp and DVm after treatment(P<0.01).(4)Compared with that in control group,observation group showed similar NIHSS score before treatment(P>0.05),but lower NIHSS score after treatment(P<0.01).(5)There was no statistically significant difference in incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusion Edaravone injection combined with shenmai injection has certain clinical effect in treating elderly patients with ischemic stroke,which can effectively improve the serum Vaspin level and cerebral hemodynamics,reduce the serum Resistin level,and promote the recovery of neurological function,with relatively high safety.