吡拉西坦联合鼠神经生长因子对急性缺血性脑卒中患者的疗效及对神经内分泌因子、脑血流的影响

Effect of Piracetam Combined with Rat Nerve Growth Factor on Acute Ischemic Stroke and Its Effects on Neuroendocrine Factors and Cerebral Blood Flow

目的 探究与分析吡拉西坦联合鼠神经生长因子对急性缺血性脑卒中患者的疗效及对神经内分泌因子、脑血流指标的影响。方法 方便选取2018年2月—2021年11月新泰市人民医院收治的147例急性缺血性脑卒中患者作为研究对象,按照就诊时间先后顺序分为对照组(n=60),采用吡拉西坦治疗;观察组(n=87),在对照组基础上加用鼠神经生长因子治疗。对比两组临床疗效、治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、蒙特利尔认知评估量表(MoCA)评分,神经内分泌因子[神经元特异性烯醇化酶(NSE)、胰岛素样生长因子(IGF-1)、神经肽(NPY)、氧化应激因子(MPO、LPO)、Tau蛋白及视锥蛋白样蛋白-1(VILIP-1)]水平,同时采用超声多普勒诊断仪对基底动脉、左右大脑中动脉血流进行测量。结果 观察组与对照组相比临床总有效率(83.33%vs 94.25%)较高,差异有统计学意义(χ^(2)=4.621,P=0.032)。治疗后,观察组NIHSS评分[(8.77±1.54)分]低于对照组,MoCA评分[(27.58±2.42)分]高于对照组,差异有统计学意义(t=17.388、4.739,P<0.001)。治疗后,观察组血清NSE(8.41±3.12)ng/mL、Tau蛋白(115.52±22.74)pg/mL、NPY(105.25±26.99)ng/L、MPO(71.60±7.55)mg/L、LPO(26.25±4.11)μmol/L、VILIP-1(306.74±55.25)pg/mL低于对照组,但IGF-1(168.25±27.11)ng/mL高于对照组,差异有统计学意义(P<0.05)。观察组基底动脉(43.98±6.82)mL/min、大脑中动脉(左)(64.30±9.33)mL/min、大脑中动脉(右)(63.90±9.13)mL/min脑血流量速度高于对照组,差异有统计学意义(P<0.05)。结论 吡拉西坦联合鼠神经生长因子治疗急性缺血性脑卒中具有较高的临床疗效,促进改善患者的神经功能,调节神经内分泌因子水平以及脑血流指标,预后表现更好。

Objective To explore and analyze the effect of piracetam combined with rat nerve growth factor on patients with acute ischemic stroke and the effect on neuroendocrine factors and cerebral blood flow indexes.Methods A total of one hundred and forty-seven patients with acute ischemic stroke admitted to Xintai People's Hospital from February 2018 to November 2021 were conveniently selected as subjects.The patients in the control group(n=60)were treated with piracetam,and the patients in the observation group(n=87)were treated with rat nerve growth factor.Clinical efficacy,national institutes of health stroke scale(NIHSS)scores,montreal cognitive assessment scale(MoCA)scores,neuroendocrine factor[neuron specific enolase(NSE),insulin-like growth factor(IGF-1),neuropeptide(NPY),oxidative stress factors(MPO,LPO),tau protein,and cone like protein-1(VILIP-1)]were compared before and after treatment between two groups. At the same time, the blood flow of basilar artery and left and right middle cerebral artery was measured by ultrasonic Doppler diagnostic instrument. Results Compared with the control group, the observation group had a higher clinical total effective rate (83.33% vs 94.25%), and the difference was statistically significant(χ^(2)=4.621, P=0.032). After treatment, the NIHSS score (8.77±1.54) points in the observation group was lower than thatin the control group, while the MoCA score (27.58±2.42) points was higher than that in the control group, and the difference was statistically significant (t=17.388, 4.739, P<0.001). After treatment, the observation group had serum NSE(8.41±3.12) ng/mL, Tau protein (115.52±22.74) pg/mL, NPY (105.25±26.99) ng/L, MPO (71.60±7.55) mg/L, and LPO(26.25±4.11) μmol/L and VILIP-1 (306.74±55.25) pg/mL were lower than the control group, but IGF-1 (168.25±27.11)ng/mL was higher than the control group, and the difference was statistically significant (P<0.05). The cerebral bloodflow velocity of the basilar artery (43.98±6.82) mL/min, middle cerebral artery (left) (64.30±9.33) mL/min, and middlecerebral artery (right) (63.90±9.13) mL/min in the observation group was higher than that of the control group, and thedifference was statistically significant (P<0.05). Conclusion Piracetam combined with rat nerve growth factor in thetreatment of acute ischemic stroke has a higher clinical effect, promoting the improvement of the neurological functionof patients, regulating the level of neuroendocrine factors and cerebral blood flow indicators, and a better prognosis.