奥拉西坦对急性缺血性脑卒中的临床疗效和初步机制探讨

Clinical effects of oxiracetam treated for acute cerebral infarction

目的:研究奥拉西坦对急性缺血性脑卒中的临床疗效并初步探讨机制。方法:选取我院2017年1月~2020年1月诊治的急性缺血性脑卒中患者194例,按随机数字表法分为奥拉西坦组(n=98)和对照组(n=96),对照组按指南推荐予常规治疗,奥拉西坦组在对照组基础上加用奥拉西坦,比较两组患者治疗前及后14d美国国立卫生研究院脑卒中量表(NIHSS)评分、血清S100B、神经元特异性烯醇化酶(NSE)、C反应蛋白(CRP)、白介素1-β(IL1-β)、超氧化物歧化酶(SOD)、血管性血友病因子(vWF),评价临床疗效,比较并发症发生情况。结果:两组治疗前NIHSS评分差异无统计学意义,两组在治疗后14d NIHSS评分均较治疗前下降,差异具有统计学意义,奥拉西坦组治疗后14d NIHSS评分低于对照组,差异具有统计学意义。奥拉西坦组有效率为84.7%,对照组有效率为77.1%,差异具有统计学意义。两组患者治疗前血清S100B、NSE、CRP、IL1-β、SOD、vWF差异无统计学意义;两组治疗后14d血清S100B、NSE、CRP、IL1-β、vWF均较治疗前下降,SOD较治疗前上升,差异具有统计学意义;奥拉西坦组治疗后14d血清S100B、NSE、CRP、IL1-β、vWF低于对照组,差异具有统计学意义;奥拉西坦组SOD与对照组差异无统计学意义。暂未发现奥拉西坦组并发症多于对照组的证据。结论:奥拉西坦能保护神经元,改善病情及预后,具有较好的临床疗效。

Objective To study the clinical effects of oxiracetam treated for acute cerebral infarction and discuss the mechanism.Method 194 cases acute cerebral infarction patients in our hospital from January 2017 to January 2020were selected,and divided into oxiracetam group (n=98) and control group (n=96) according to random number table.Patients in control group were given conventional therapy according to the Handbook,while in oxiracetam group were added oxiracetam based on control group.Before the treatment and 14d after administration,the NIHSS,S100B,NSE,CRP,IL-1β,SOD,vWF were compared between two groups,the clinical effects were evaluated and complications were observed.Result Before the treatment,the NIHSS score had no statistical difference between two groups,the NIHSS score of 14d after treatment were less than that before the treatment in two groups,the NIHSS score of 14d after treatment in oxiracetam group were less than that in control group.The effective rate in oxiracetam group which was 84.7% was higher than that in control group which was 77.1%.Before the treatment,the S100B,NSE,CRP,IL-1β,SOD,vWF had no statistical difference between two groups,the S100B,NSE,CRP,IL-1β,vWF of 14d after treatment were less than that before the treatment and SOD was higher than that before the treatment in two groups,the S100B,NSE,CRP,IL-1β,vWF of 14d after treatment in oxiracetam group were less than that in control group,but the SOD had no statistical difference between two groups.Conclusion Oxiracetam can protect the neuron,improve pathogenic condition and prognosis,and has good clinical effects.