马来酸桂哌齐特联合阿替普酶治疗急性脑卒中的效果观察

Effect of cinepazide maleate combined with alteplase in the treatment of acute stroke

目的研究探讨马来酸桂哌齐特联合阿替普酶治疗急性缺血性脑卒中的效果观察及对患者髓过氧化物酶(MPO)、基质金属蛋白酶2(MMP-2)、脑源性神经营养因子(BDNF)水平的影响。方法回顾性选取2019年10月~2020年10月期间南通大学附属如皋医院收治的95例急性缺血性脑卒中患者,按患者治疗方法不同分为观察组(48例)、对照组(47例)。对照组给予阿替普酶治疗,观察组在对照组增加马来酸桂哌齐特治疗。评估比较两组患者的临床疗效、认知功能评分、MPO、MMP-2、BDNF、血液流变学指标、不良反应发生率。结果观察组总有效率为91.67%(44/48),高于对照组患者为74.47%(35/47),差异有统计学意义(P<0.05)。治疗后观察组患者的神经功能缺损评分(NIHSS)低于对照组,简易智力状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)评分高于对照组,差异有统计学意义(P<0.05)。治疗后观察组患者的MPO、MMP-9低于对照组,BDNF水平高于对照组,差异有统计学意义(P<0.05)。治疗后观察组全血黏度、血浆黏度、红细胞变形指数、纤维蛋白原水平均低于对照组,差异有统计学意义(P<0.05)。治疗期间观察组、对照组不良反应发生率为16.67%(8/48)、10.64%(5/47),差异无统计学意义(P>0.05)。结论马来酸桂哌齐特联合阿替普酶治疗急性缺血性脑卒中的效果显著,可改善患者的认知功能,降低MPO、MMP-9水平,提升BDNF水平,降低患者的血液流变学指标,治疗安全性良好。

Objective To study the effect of cinepazide maleate combined with alteplase in the treatment of acute cerebral apoplexy and its influence on the levels of myeloperoxidase(MPO),matrix metalloproteinase-2(MMP-2)and brain-derived neurotrophic factor(BDNF).Methods 95 cases of patients with acute stroke in our hospital from October 2019 to October 2020 were selected as the research objects and divided into observation group(48 cases)and control group(47 cases)according to different treatment methods.The control group was treated with alteplase,and the observation group was treated with cinepazide maleate.After 3 courses of treatment,the clinical efficacy,cognitive function score,MPO,MMP-2,BDNF,hemorheology indexes and the incidence of adverse reactions were compared between the two groups.Results the total effective rate of the observation group was 91.67%(44/48),which was higher than 74.47%(35/47)of the control group(P<0.05).After treatment,NIHSS of observation group was lower than that of control group,MMSE and MOCA were higher than those of control group(P<0.05).After treatment,MPO and MMP-9 in the observation group were lower than those in the control group,and BDNF level was higher than that in the control group(P<0.05).After treatment,the whole blood viscosity,plasma viscosity,erythrocyte deformation index and fibrinogen in the observation group were lower than those in the control group(P<0.05).During the treatment,the incidence of adverse reactions in the observation group and the control group was 16.67%(8/48)and 10.64%(5/47)(P>0.05).Conclusion cinepazide maleate combined with alteplase has a significant effect in the treatment of acute stroke,which can improve the cognitive function of patients,reduce the levels of MPO and MMP-9,enhance the level of BDNF,reduce the hemorheological indexes of patients,and has good safety,which can be recommended in clinical practice.