吡拉西坦联合神经介入术治疗急性脑梗死临床观察

Clinical Observation of Piracetam Combined with Neurological Intervention in the Treatment of Acute Cerebral Infarction

目的探讨吡拉西坦联合神经介入术治疗急性脑梗死(ACI)的临床疗效。方法选取江苏省张家港市第一人民医院2020年1月至2022年1月收治的ACI患者114例,按随机数字表法分为观察组和对照组,各57例。两组患者均予神经介入术及双抗(口服阿司匹林肠溶片和硫酸氢氯吡格雷片)治疗,观察组患者加用吡拉西坦注射液静脉滴注。两组均治疗20 d。结果观察组总有效率为92.98%,显著高于对照组的78.95%(P<0.05)。治疗后,观察组的美国国立卫生研究院卒中量表评分显著低于对照组,简易精神状态评价量表评分显著高于对照组,血清髓鞘碱性蛋白、中枢神经系统特异蛋白水平及动-静脉血氧含量差、脑氧摄取率均显著低于对照组,血清神经生长因子水平及颈静脉血氧饱和度均显著高于对照组(P<0.05)。观察组与对照组不良反应发生率相当(10.53%比3.51%,P>0.05)。结论吡拉西坦联合神经介入术治疗ACI,可有效改善患者的脑氧代谢,修复受损神经功能。

Objective To investigate the clinical efficacy of piracetam combined with neurological intervention in the treatment of acute cerebral infarction(ACI).Methods A total of 114 patients with ACI admitted to the Zhangjiagang First People's Hospital from January 2020 to January 2022 were selected and divided into the observation group and the control group by the random number table method,with 57 cases in each group.The patients in the two groups were given the neurological intervention and dual-antiplatelet therapy(taking Aspirin Enteric-Coated Tablets and Clopidogrel Bisulfate Tablets orally),on this basis,the patients in the observation group were given intravenous drip of Piracetam Injection.Both groups were treated for 20 d.Results The total effective rate in the observation group was 92.98%,which was significantly higher than 78.95%in the control group(P<0.05).After treatment,the National Institutes of Health Stroke Scale(NIHSS)score in the observation group was significantly lower than that in the control group;the Mini-Mental Status Examination(MMSE)score was significantly higher than that in the control group;the serum myelin basic protein(MBP)level,central nerve specific protein(S100β)level,arterio-venous oxygen content difference(AVDO_(2))and cerebral extraction rate of oxygen(CERO_(2))were significantly lower than those in the control group;the serum nerve growth factor(NGF)level and jugular venous oxygen saturation(SjvO_(2))were significantly higher than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was similar to that in the control group(10.53%vs.3.51%,P>0.05).Conclusion Piracetam combined with neurological intervention can effectively improve cerebral oxygen metabolism and repair damaged neurological function in patients with ACI.