人参皂苷Rd注射液联合阿替普酶对急性缺血性脑卒中患者认知功能及相关因子的影响

Effects of ginsenoside Rd injection combined with alteplase on cognitive function and related factors in patients with acute ischemic cerebral stroke

目的研究人参皂苷Rd注射液联合注射用阿替普酶对急性缺血性脑卒中患者认知功能及相关因子的影响。方法急性缺血性脑卒中患者180例随机分为对照组和治疗组,每组90例。对照组在常规治疗和护理基础上给予注射用阿替普酶治疗,治疗组在对照组基础上联合应用人参皂苷Rd注射液治疗,疗程2周。观察2组治疗前后简易智能状态量表(MMSE)、蒙特利尔认知评估量表(Mo CA)评分、嗜睡量表(ESS)评分。采用颅脑CT扫描仪计算缺血面积,并检测脑血流量(CBF)、脑血容量(CBV)等脑血流灌注指标。采用化学发光法检测血清超氧化物歧化酶(SOD)水平。采用酶联免疫吸附实验(Elisa)检测血清丙二醛(MDA)、脑源性神经营养因子(BNDF)、S100B水平。结果2组治疗前MMSE评分、Mo CA评分、ESS评分、缺血面积、CBV、CBF及血清SOD、MDA、BNDF、S100B比较差异无统计学意义(P>0.05);与治疗前比较,2组治疗后MMSE评分、Mo CA评分及血清SOD、BNDF均显著增加,ESS评分及血清MDA、S100B均显著降低,缺血面积均显著缩小,差异均有统计学意义(P<0.05),且治疗组治疗后上述指标与对照组比较,差异有统计学意义(P<0.05)。结论人参皂苷Rd注射液联合注射用阿替普酶治疗急性缺血性脑卒中患者,可以显著缩小脑梗死面积,改善脑血流灌注状态,并提高患者认知功能,机制与减轻氧化应激损伤有关。

Objective To investigate the effects of ginsenoside Rd injection combined with alteplase on cognitive function and related factors in patients with acute ischemic cerebral stroke.Methods A total of 180 patients with acute ischemic cerebral stroke who were admitted and treated in our hospital from October 2012 to July 2014 were enrolled in the study,who were randomly divided into treatment group(n=90)and control group(n=90).The patients in control group,on the basis of conventional therapy and nursing,were treated by alteplase injection,and the patients in treatment group,on the basis of control grouo,were treated by ginsenoside Rd injection,with a treatment course of two weeks for both groups.The MMSE score,MoCA score,ESS score,ischemic area,CBF,CBV,and the serum levels of SOD,MDA,BNDF and S100B were observed and compared between the two groups.Results Before treating,there were no significant differences in MMSE scores,MoCA scores,ESS scores,ischemic area,CBF,CBV,and the serum levels of SOD,MDA,BNDF and S100B between the two groups(P>0.05).After treatment,the MMSE scores,MoCA scores and serum levels of SOD and BNDF were significantly increased in both groups,however,the ESS scores and serum levels of MDA and S100B were significantly decreased,and ischemic area was significantly decreased in both groups(P<0.05),moreover,there were significant differences in above indexes between the two groups(P<0.05).Conclusion Ginsenoside Rd injection combined with alteplase in treatment of acute ischemic cerebral stroke can significantly decrease the area of cerebral infarction,improve cerebral blood flow perfusion,and improve the cognitive function of patients,and its action mechanism may be related to alleviating oxidative stress injury.