盐酸川芎嗪联合奥扎格雷对急性脑梗死患者神经功能缺损和血液流变学的影响

Effect of ligustrazine hydrochloride combined with ozagrel on neurological deficit and hemorheology in patients with acute cerebral infarction

目的应用盐酸川芎嗪联合奥扎格雷治疗急性脑梗死患者,评估其神经功能缺损和血液流变学的改善作用。方法选择2018年2月—10月急性脑梗死患者100例,随机分为对照组和治疗组,两组各50例。两组患者均给予溶栓、抗凝、脱水降颅内压、营养神经、预防并发症等常规治疗,对照组患者给予奥扎格雷钠进行治疗,治疗组患者应用盐酸川芎嗪联合奥扎格雷治疗。分别于治疗前后,应用美国国立卫生研究院卒中量表(NIHSS)和Barthel指数评分(BI评分)评估患者神经功能和日常生活能力改善状况,评估椎动脉、基底动脉血流速度,检测治疗前后患者血流变学指标及血小板计数(PLT)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)水平。结果治疗后治疗组椎动脉、基底动脉血流速度和BI评分分别为(51.29±2.83)cm/s、(53.54±2.97)cm/s和(74.83±4.73)分,高于对照组(49.23±2.91)cm/s、(51.07±3.28)cm/s和(70.58±4.64)分,差异具有统计学意义(P<0.05);治疗后治疗组NIHSS评分为(21.36±3.35)分,低于对照组(24.55±3.84),差异具有统计学意义(P<0.05)。治疗组全血黏度(高切、低切)、血浆黏度、红细胞压积和APTT分别为(3.91±0.72)mPa·s、(10.14±0.95)mPa·s、(1.17±0.20)mPa·s、(4.36±0.35)和(22.83±0.96)s,均低于对照组(5.14±0.75)mPa·s、(11.25±0.98)mPa·s、(1.69±0.24)mPa·s、(5.75±0.39)和(25.74±0.92)s,差异具有统计学意义(P<0.05)。结论应用盐酸川芎嗪联合奥扎格雷治疗急性脑梗死患者,能够显著提高患者脑部血流,改善血液流变学状况,促进患者神经功能恢复和日常生活质量的提高。

Objective To evaluate the effect of ligustrazine hydrochloride combined with ozagrel on neurological deficit and hemorheology in patients with acute cerebral infarction.Methods 100 patients with acute cerebral infarction admitted to hospital from February to October,2018 were randomly divided into the control group and the treatment group,with 50 patients in each group.Both groups were given conventional treatment such as thrombolysis,anticoagulation,intracranial pressure reduction by dehydration,neurotrophic treatment,and complication prevention.The control group was treated with sodium ozagrel,and the treatment group was treated with ligustrazine hydrochloride and ozagrel.National Institutes of Health Stroke Scale(NIHSS)and Barthel Index score(BI)were used to assess the improvement of neurological function and daily living ability;blood flow velocity of vertebral artery and basilar artery was measured;hemorheological parameters,platelet count(PLT),activated partial thromboplastin time(APTT),prothrombin time(PT),and fibrinogen(FIB)levels were detected.Results The vertebral artery and basilar artery blood flow velocity and BI score in the treatment group were(51.29±2.83)cm/sec,(53.54±2.97)cm/sec and(74.83±4.73)respectively,which were higher than those in the control group(49.23±2.91)cm/sec,(51.07±3.28)cm/sec and(70.58±4.64),with significant difference(P<0.05).NIHSS score in the treatment group after treatment was(21.36±3.35),which was lower than that in the control group(24.55±3.84),with significant difference(P<0.05).The whole blood viscosity(high shear,low shear),plasma viscosity,hematocrit and APTT in the treatment group were(3.91±0.72)mPaos,(0.14±0.95)mPaos,(1.17±0.20)mPaos,(4.36±0.35)and(22.83±0.96)s,which were lower than those in the control group(5.14±0.75)mPaos,(11.25±0.98)mPaos,(1.69±0.24)mPaos,(5.75±0.39)and(25.74±0.92)s,with significant difference(P<0.05).Conclusion Theapplication of ligustrazine hydrochloride combined with ozagrel in the treatment of acute cerebral infarction can significantly improve blood flow in the brain,improve the Hemorheology,and promote the recovery of neurological function and the quality of life.