前列地尔注射液对缺血性脑卒中患者神经功能恢复、血液流变学及血清炎症因子的影响

Effects of alprostadil injection on nerve function recovery,hemorheology,and serum inflammatory factors in patients with ischemic stroke

目的探讨前列地尔注射液对缺血性脑卒中患者神经功能恢复、血液流变学及血清炎症因子的影响。方法选取2018年3月至2019年5月深圳市第二人民医院收治的缺血性脑卒中患者100例,按照数字随机表法将患者分为观察组(50例)及对照组(50例)。对照组行神经内科常规性治疗,观察组在对照组基础上联合前列地尔注射液进行治疗,对比分析2组患者治疗前后神经功能、血液流变学[纤维蛋白原(FIB)、血浆黏度(PV)、全血低切黏度(LBV)、红细胞刚性指数(ERI)]及血清炎症因子[人高前移率族蛋白B1(HMG-B1)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)]水平的变化。结果在治疗前,2组患者各项基线资料差异不显著(P>0.05)。治疗后,观察组治疗总有效率(96%)显著高于对照组(78%),差异有统计学意义(P<0.05)。2组患者治疗后神经功能、血液流变学以及血清炎症因子各项指标与治疗前相比均得到显著改善(P<0.05)。治疗后观察组与对照组NIHSS评分[(13.43±4.08)分vs(19.67±4.06)分,P<0.05]、MoCA评分[(28.75±2.76)分vs(26.06±2.64)分,P<0.05]、ADL评分[(90.26±5.27)分vs(76.16±5.82)分,P<0.05]比较,差异有统计学意义。治疗后,观察组FIB[(2.07±0.32)g/L]、PV[(2.04±0.65)mPa.s]、LBV[(15.06±3.42)mPa.s]、ERI(2.42±0.11)较对照组[FIB(3.35±0.41)g/L、PV(3.56±0.70)mPa.s、LBV(18.44±3.18)mPa.s、ERI(3.47±0.24)]显著降低(P<0.05)。治疗后,观察组血清HMG-B1[(4.54±1.12)μg/ml]、IL-8[(64.62±11.54)pg/ml]、TNF-α[(36.17±4.67)mmol/L]较对照组[HMG-B1(8.65±1.67)μg/ml、IL-8(88.64±9.17)pg/ml、TNF-α(59.45±4.09)mmol/L]显著降低(P<0.05)。结论前列地尔注射液能有效改善缺血性脑卒中患者血液流变学,抑制血清炎症因子释放,减轻患者脑损伤程度,有助于患者神经功能恢复,改善患者预后。

Objective To explore the effects of alprostadil injection on the recovery of nerve function,blood rheology,and serum inflammatory factors in patients with ischemic stroke.Methods From March 2018 to May 2019,100 patients with ischemic stroke admitted to Shenzhen Second People's Hospital were selected,and the patients were divided into either an observation group(n=50)or a control group(n=50)using a random number table.Both groups received conventional neurology treatment,and the observation group was additionally treated with alprostadil injection.The changes in nerve function,blood rheology,and serum inflammatory factor levels of the two groups before and after treatment were compared and analyzed.Results Before treatment,there was no significant difference in baseline information between the two groups(P>0.05).The total effective rate in the observation group was significantly higher than that of the control group(96%vs 78%,P<0.05).Compared with the values before treatment,neurological function,blood rheology,serum inflammatory factors,and other indicators were significantly improved after treatment in both groups(P<0.05).After treatment,NIHSS score[(13.43±4.08)vs(19.67±4.06),P<0.05],MoCA score[(28.75±2.76)vs(26.06±2.64),P<0.05],and ADL score[(90.26±5.27)vs(76.16±5.82),P<0.05]differed significantly between the observation group and control group;FIB[(2.07±0.32)g/L vs(3.35±0.41)g/L],PV[(2.04±0.65)mPa.s vs(3.56±0.70)mPa.s],LBV[(15.06±3.42)mPa.s vs(18.44±3.18)mPa.s],and ERI[(2.42±0.11)vs(3.47±0.24)]were significantly lower in the observation group than in the control group(P<0.05);serum HMG-B1[(4.54±1.12)μg/ml vs(8.65±1.67)μg/ml],IL-8[(64.62±11.54)pg/ml vs(88.64±9.17)pg/ml],and TNF-α[(36.17±4.67)mmol/L vs(59.45±4.09)mmol/L]were also significantly lower in the observation group than in the control group(P<0.05).Conclusion Alprostadil injection can effectively improve hemorheology,inhibit the release of serum inflammatory factors,reduce the degree of brain injury,promote neurological function recovery,and improve prognosis in patients with ischemic stroke.