胞磷胆碱联合氯吡格雷对缺血性脑卒中患者神经功能的影响

The Effect of Citicoline Combined with Clopidogrel on Neurological Function in Patients with Ischemic Stroke

目的 探讨胞磷胆碱联合氯吡格雷治疗缺血性脑卒中的临床效果及对患者神经功能的影响。方法 选取2018年7月~2021年7月我院收治的缺血性脑卒中患者84例,按随机数字表法分为两组,各42例。两组均接受常规治疗,对照组予以氯吡格雷治疗,观察组加用胞磷胆碱治疗,持续治疗14 d。比较两组临床疗效、神经功能、日常生活能力、血清学指标、炎症水平及不良反应情况。结果 观察组总有效率较对照组高,差异有统计学意义(P<0.05);观察组治疗后NIHSS评分为(10.34±1.56)分,低于对照组,BI评分为(60.69±6.25)分,高于对照组,差异有统计学意义(P<0.05);观察组治疗后同型半胱氨酸(Hcy)、血小板颗粒膜蛋白140(CMP-140)、神经元特异性烯醇化酶(NSE)水平为(10.23±1.52)μmol·L^(-1)、(8.75±1.12)μg·L^(-1)、(9.52±1.14)μg·L^(-1),低于对照组,差异有统计学意义(P<0.05);观察组治疗后超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平为(5.68±1.14)mg·L^(-1)、(18.96±2.23)pg·mL^(-1),低于对照组,差异有统计学意义(P<0.05);两组不良反应相比,差异无统计学意义(P>0.05)。结论 胞磷胆碱联合氯吡格雷可提高缺血性脑卒中治疗效果,减轻脑部炎症反应,加快血清Hcy、CMP-140、NSE水平复常,促进神经功能恢复,安全可靠。

OBJECTIVE To investigate the clinical effect of citicoline combined with clopidogrel in the treatment of ischemic stroke and its influence on patients’ neurological function.METHODS A total of 84 patients with ischemic stroke admitted to our hospital from July 2018 to July 2021 were selected and divided into two groups according to the random number table method,each with 42 cases.Both groups were received conventional treatment,the control group was treated with clopidogrel,and the observation group was treated with clopidogrel and citicoline for 14 days.The clinical efficacy,neurological function,ability of daily living,serological indicators,inflammation level and adverse reactions were compared between the two groups.RESULTS The total effective rate of the observation group was higher than that of the control group,with statistical difference(P<0.05).The NIHSS score of the observation group after treatment was(10.34±1.56) points,which was lower than that of the control group,and the BI score was(60.69±6.25)points,which was higher than the control group,the difference was statistically significant(P<0.05).After treatment in the observation group,The levels of homocysteine(Hcy),platelet granule membrane protein 140(CMP-140),neuron-specific enolase(NSE) were(10.23±1.52) μmol·L^(-1),(8.75±1.12) μg·L^(-1),(9.52±1.14) μg·L^(-1),which were lower than those of the control group,and the differences were statistically significant(P<0.05).The levels of sensitive C-reactive protein(hs-CRP) and tumor necrosis factor-α(TNF-α) were(5.68±1.14) mg·L^(-1)and(18.96±2.23) pg·mL^(-1),which were lower than those of the control group,with statistical differences(P<0.05).There was no statistical difference in adverse reactions between the two groups(P>0.05).CONCLUSION Citicoline combined with clopidogrel can improve the therapeutic effect of ischemic stroke,reduce brain inflammation,accelerate the return of serum Hcy,CMP-140,and NSE levels,and promote the recovery of nerve function,which is safe and reliable.