己酮可可碱联合倍他司汀对急性脑梗死患者认知功能及血流动力学的影响

Effects of pentoxifylline combined with betahistine on cognitive function and hemodynamics in patients with acute cerebral infarction

目的 探讨己酮可可碱联合倍他司汀对急性脑梗死(ACI)患者认知功能及血流动力学的影响。方法 选取2020年1月至2022年5月西南医科大学附属自贡医院收治的ACI患者84例,按照随机数字表法分为试验组(42例)和对照组(42例)。两组均接受标准静脉溶栓治疗,对照组给予盐酸倍他司汀静脉滴注,试验组加用己酮可可碱缓释片治疗,连续治疗3w。对比两组治疗前后美国国立卫生研究院卒中量表(NIHSS)、简易精神状态量表(MMSE)、Barthel指数、血流动力学变化。结果 试验组治疗总有效率(92.86%),显著高于对照组76.19%(P<0.05)。治疗后,两组NIHSS评分明显降低,MMSE评分、Barthel指数则显著升高(P<0.05),且试验组NIHSS评分低于对照组,MMSE评分及Barthel指数高于对照组(P<0.05)。治疗后,两组血浆黏度、全血黏度(高切、低切)及红细胞聚集指数均明显降低(P<0.05),且试验组各血流动力学指标水平低于对照组(P<0.05)。治疗后,两组患者血清SOD水平升高,血清MDA水平显著降低(P<0.05),且试验组血清SOD水平高于对照组,血清MDA水平低于对照组(P<0.05)。结论 己酮可可碱联合倍他司汀能改善ACI患者血流动力学状况,降低氧化应激反应,提高认知功能,值得临床推广。

Objective To investigate the effects of pentoxifylline combined with betahistine on cognitive function and hemodynamics in patients with acute cerebral infarction(ACI).Methods A total of 84 patients with ACI admitted to our hospital from January 2020 to May 2022 were selected and divided into experimental group(42 cases)and control group(42 cases)according to random number table method.Both groups received standard intravenous thrombolytic therapy,the control group was given intravenous infusion of betahistine hydrochloride,the experimental group was treated with hexantheobromine sustained-release tablets,continuous treatment for 3 weeks.The national Institutes of Health Stroke Scale(NIHSS),mini-Mental State Scale(MMSE),Barthel index and hemodynamics were compared between the two groups before and after treatment.Results The total effective rate of experimental group(92.86%)was significantly higher than that of control group(76.19%)(P<0.05).After treatment,NIHSS score was significantly decreased in both groups,while MMSE score and Barthel index were significantly increased(P<0.05).NIHSS score in experimental group was lower than that in control group,while MMSE score and Barthel index were higher than that in control group(P<0.05).After treatment,plasma viscosity,whole blood viscosity(high cut,low cut)and erythrocyte aggregation index were significantly decreased in both groups(P<0.05),and hemodynamics indexes in experimental group were lower than those in control group(P<0.05).After treatment,the serum SOD level in two groups was increased and the serum MDA level was significantly decreased(P<0.05),and the serum SOD level in experimental group was higher than that in control group,while the serum MDA level was lower than that in control group(P<0.05).Conclusion Pentoxifylline combined with betahistine can improve hemodynamics,reduce oxidative stress response and improve cognitive function in ACI patients,which is worthy of clinical promotion.