奥拉西坦联合胞磷胆碱治疗急性脑梗死的临床研究

Clinical study on oxiracetam combined with citicoline in treatment of acute cerebral infarction

目的研究奥拉西坦联合胞磷胆碱治疗急性脑梗死的临床效果。方法选择2018年3月—2019年10月新乡市中心医院收治的急性脑梗死患者104例为研究对象,采用随机信封法将患者分为替格瑞洛联合胞磷胆碱组(对照组)和奥拉西坦联合胞磷胆碱组(治疗组),每组各52例。对照组患者静脉滴注胞磷胆碱注射液,0.5 g加入到100 mL 5%葡萄糖注射液中,1次/d;同时口服替格瑞洛片,90 mg/次,2次/d。治疗组患者静脉滴注胞磷胆碱注射液,0.5 g加入到100 mL 5%葡萄糖注射液中,1次/d;同时静脉滴注奥拉西坦注射液,5 g加入到250 mL 5%葡萄糖注射液中,1次/d。两组患者均连续治疗3周。观察两组的临床疗效,比较两组的神经功能缺损(NIHSS)评分、蒙特利尔认知评估量表(MoCA)评分,并比较两组患者血清血管内皮生长因子(VEGF)、神经元特异性烯醇化酶(NSE)水平、炎症因子水平。结果治疗后,两组患者总有效率比较差异无统计学意义。治疗后,两组患者NIHSS评分较治疗前明显降低,MoCA评分明显升高(P<0.05);治疗后治疗组MoCA评分显著高于对照组(P<0.05),治疗后两组NIHSS评分比较无统计学意义。治疗后,两组患者血清VEGF水平均较治疗前明显升高,NSE水平明显降低(P<0.05);且治疗组患者血清VEGF水平明显高于对照组,NSE水平明显低于对照组(P<0.05)。治疗后,两组患者肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平较治疗前明显降低(P<0.05);且治疗组患者TNF-α、IL-6水平降低幅度高于对照组(P<0.05)。结论奥拉西坦联合胞磷胆碱治疗急性脑梗死具有较好的疗效,可改善认知功能,降低血清炎症因子水平,具有一定临床推广应用价值。

Objective To study the clinical effects of Oxiracetam Injection combined with Citicoline Sodium Injection in treatment of acute cerebral infarction.Methods Patients(104 cases)with acute cerebral infarction in Xinxiang Central Hospital from March 2018 to October 2019 were randomly divided into the ticagrelor combined with citicoline group(control group)and the oxiracetam combined with citicoline group(treatment group),and each group had 52 cases.Patients in the control group were iv administered with Citicoline Sodium Injection,0.5 g added into 5%glucose solution 100 mL,once daily,and also po administered with Ticagrelor Tablets at the same time,90 mg/time,twice daily.Patients in the treatment group were iv administered with Citicoline Sodium Injection,0.5 g added into 5%glucose solution 100 mL,once daily,and also iv administered with Oxiracetam Injection at the same time,0.5 g added into 5%glucose solution 250 mL,once daily.Patients in two groups were treated for 3 weeks.After treatment,the clinical efficacies were evaluated,and NIHSS score,MoCA score,the serum levels of VEGF,NSE,and inflammatory factors in two group were compared.Results After treatment,the total effective rates of two groups were not statistically significant.After treatment,NIHSS score of two groups was significantly lower than that before treatment,but MOCA score of two groups was significantly increased(P<0.05).After treatment,MOCA score of the treatment group was significantly higher than that of the control group(P<0.05),and NIHSS score of two groups was not statistically significant after treatment.After treatment,the serum level of VEGF in two groups was significantly higher than that before treatment,but the serum level of NSE was significantly decreased(P<0.05).And the serum level of VEGF the treatment group was significantly higher than that of the control group,but the serum level of NSE was significantly lower than that of the control group(P<0.05).After treatment,the levels of TNF-αand IL-6 in two groups were significantly lower than those before treatment(P<0.05),and the levels of TNF-αand IL-6 in the treatment group were significantly lower than those in the control group(P<0.05).Conclusion Oxiracetam Injection combined with Citicoline Sodium Injection has clinical curative effect in treatment of acute cerebral infarction,can improve cognitive function,and reduce the serum level of inflammatory factors.