血栓通与尤瑞克林联合对急性脑梗死患者神经及硬化斑块稳定性影响的研究

Study on the Effect of Xueshuantong Combined with Urinary Kallidinogenase on Nerve and Sclerotic Plaque Stability in Patients with Acute Cerebral Infarction

目的:研究血栓通联合尤瑞克林在急性脑梗死(ACI)患者治疗中的应用价值。方法:将2020年11月至2022年4月南阳市宛城区第一人民医院118例ACI患者按照随机双盲法分为两组。入院后患者均给予基础治疗,常规组(59例)予以尤瑞克林+安慰剂治疗,联合组(59例)采用尤瑞克林联合血栓通治疗。对比两组临床疗效、治疗前后神经缺损程度(NIHSS评分)、生活质量(ADL评分)、斑块稳定性、凝血纤溶功能指标、血清CXC趋化因子配体16(CXCL16)、S100钙结合蛋白A12(S100A12)、单核细胞趋化因子(MCP-1)、脂蛋白磷脂酶A2(Lp-PLA2)水平。结果:联合组总有效率94.92%高于常规组83.05%(P<0.05)。治疗后与常规组比较,联合组NIHSS评分较低,ADL评分较高(P<0.05);联合组斑块总面积较小,动脉粥样硬化斑块(Crouse)积分较低,动脉内膜中层厚度(IMT)较薄(P<0.05)。治疗后与常规组比较,联合组α颗粒膜蛋白-140(GMP-140)、纤溶酶原激活物抑制剂-1(PAI-1)水平较低,纤溶酶原激活物(t-PA)水平较高(P<0.05);联合组血清CXCL16、S100A12、Lp-PLA2、MCP-1水平均较低(P<0.05)。结论:尤瑞克林与血栓通联合能提高ACI患者疗效,减轻炎症反应,改善凝血纤溶功能,提高斑块稳定性,减缓神经损伤,提高预后生存能力。

Objective:To study the application value of xueshuantong combined with urinary kallidinogenase in the treatment of patients with acute cerebral infarction(ACI).Methods:From November 2020 to April 2022,118 patients with ACI in The First People's Hospital of Wancheng Districtwere randomly divided into two groups according to double-blind method.After admission,the patients were all given basic treatment,the routine group(59 cases)was treated with urinary kallidinogenase+placebo,and the combined group(59 cases)was treated with urinary kallidinogenase combined with xueshuantong.The clinical efficacy,neurological deficit degree(NIHSS score),quality of life(ADL score),plaque stability,coagulation and fibrinolysis function indexes,serum CXC chemokine ligand 16(CXCL16),S100 calcium binding protein A12(S100A12),monocyte chemokine(MCP-1),lipoprotein phospholipase A2(Lp-PLA2)levels were compared between the two groups before and after treatment.Results:The total effective rate(94.92%)in the combined group was higher than that in the routine group(83.05%)(P<0.05).After treatment,compared with the routine group,the NIHSS score of the combined group was lower and the ADL score was higher(P<0.05).The total plaque area in the combined group was smaller,the atherosclerotic plaque(Crouse)score was lower,and the intima-media thickness(IMT)was thinner(P<0.05).The levels of protein-140(GMP-140)and plasminogen activator inhibitor-1(PAI-1)were lower,and the level of plasminogen activator(t-PA)was higher(P<0.05);after treatment compared with the routine group,the serum levels of CXCL16,S100A12,Lp-PLA2 and MCP-1 in the combined group were lower(P<0.05).Conclusion:Urinary kallidinogenase combined with xueshuantong can improve the curative effect of ACI patients,reduce inflammatory response,improve coagulation and fibrinolysis function,improve plaque stability,slow nerve damage,and improve prognosis and survival ability.