奥拉西坦联合脑蛋白水解物治疗脑卒中颈动脉粥样斑块临床评价

Clinical Evaluation of Oxiracetam Combined with Brain Protein Hydrolysate in the Treatment of Carotid Atherosclerotic Plaque After Cerebral Stroke

目的探讨奥拉西坦联合脑蛋白水解物治疗脑卒中颈动脉粥样斑块的临床疗效,以及对患者认知功能和血液流变学的影响。方法选取医院2017年2月至2019年2月收治的脑卒中颈动脉粥样斑块患者94例,随机分为观察组和对照组,各47例。两组患者均予抗凝、溶栓、抗血小板、调血脂等基础治疗及脑蛋白水解物治疗,观察组患者加用奥拉西坦注射液,均连续治疗4周。结果观察组总有效率为89.36%,明显高于对照组的72.34%(P<0.05);治疗后,观察组患者的简易智力状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)、日常生活活动量表(ADL)评分均明显高于对照组(P<0.05),高切全血黏度(HBV)、中切全血黏度(MBV)、低切全血黏度(LBV)及基质金属蛋白酶-9(MMP-9)、髓过氧化物酶(MPO)、神经烯醇化酶(NSE)水平均明显低于对照组(P<0.05);观察组与对照组不良反应发生率相当(14.89%比8.51%,P>0.05)。结论奥拉西坦联合脑蛋白水解物治疗脑卒中颈动脉粥样斑块,能明显改善患者的认知功能、血液流变学指标及血清炎性指标水平。

Objective To investigate the clinical efficacy of oxiracetam combined with brain protein hydrolysate in the treatment of pa-tients wih carotid atherosclerotic plaque after cerebral stroke and its effect on cognitive dysfunction and hemotheology.Methods Totally94 patients with carotid atheroclerotic plaque after cerebral stroke admitted to our hospital from February 2017 to February 2019 wereselected and randomly divided into the observation group and the control group,47 cases in each group.The patients in the two groupswere given anticoagulation,thrombolysis,antiplatelet,blood lipid regulation and other basic treatment,and they were treated with brainprotein hydrolysate,on this basis,the patients in the observation group were treated with Oxiracetam Injection.Both groups were continu-ously treated for 4 weeks.ResultsThe total efiective rate of the observation group was 89.36%,which was significantly higher than72.34%of the control group(P<0.05).After treatment,the scores of Mimi-Mental State Examination(MMSE),Montreal Cognitive As-sessment Secale(MoCA)and activities of daily living scale(ADL)in the observation group were significantly higher than those in thecontrol group(P<0.05),while the levels of high shear whole blood viscosity(HBV),medium shear whole blood viscosity(MBV)lowshear whole blood viscosity(LBV),matrix metalloproteinase-9(MMP-9),myeloperoxidase(MPO)and neuron-specific enolase(NSE)inthe ohservation group were significantly lower than those in the control group(P<0.05).The incidence of adverse reactions in the ob-servation group was similar to that in the control group(14.89%nrs.8.51%,P>0.05).Conclusion Oxiracetam combined with brainprotein hydrolysate in the treatment of cerebral stroke patients with carotid atherosclerotic plaqu can significantly improve cognitive function,hemorheological indexes and serum inflammatory indexes.