消栓通络片联合依达拉奉对急性脑梗死患者脑血流动力学及预后的影响

Effect of Xiaoshuan Tongluo tablets combined with edaravone on cerebral hemodynamics and prognosis in patients with acute cerebral infarction

目的探讨消栓通络片联合依达拉奉对急性脑梗死(ACI)患者脑血流动力学及预后的影响。方法70例ACI患者,采用乱数表法将其分为观察组(36例)和对照组(34例)。对照组使用依达拉奉治疗,观察组在对照组基础上增加消栓通络片治疗。比较两组临床疗效、美国国立卫生研究院卒中量表(NIHSS)评分、脑血流动力学指标、血清炎症因子、不良发应发生情况以及预后情况。结果观察组总有效率为94.44%,高于对照组的76.47%,差异有统计学意义(P<0.05)。观察组治疗后NIHSS评分为(7.46±1.34)分,低于对照组的(9.86±2.27)分,差异有统计学意义(P<0.05)。治疗后,两组颈动脉搏动指数(PI)低于治疗前,平均血流量(Qm)、平均血流速度(Vm)大于治疗前,且观察组治疗后颈动脉PI(0.64±0.08)低于对照组的(0.79±0.11),Qm(5.67±0.32)L/min、Vm(10.87±0.58)cm/s均大于对照组的(4.31±0.42)L/min、(8.99±0.74)cm/s,差异有统计学意义(P<0.05)。治疗后,两组C反应蛋白(CRP)、白细胞介素-1β(IL-1β)、低于治疗前,且观察组治疗后CRP、IL-1β水平均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。两组治疗3个月后病死率、后遗症发生率比较,差异无统计学意义(P>0.05)。结论消栓通络片联合依达拉奉治疗ACI患者的疗效优于依达拉奉单一用药,在改善神经功能受损情况、脑血流动力学以及炎症反应方面具有一定优势,并具有安全性。

Objective To discuss the effect of Xiaoshuan Tongluo tablets combined with edaravone on cerebral hemodynamics and prognosis in patients with acute cerebral infarction(ACI).Methods A total of 70 ACI patients were divided into the observation group(36 cases)and the control group(34 cases)according to the random numerical table.The control group was treated with edaravone,and the observation group was treated with Xiaoshuan Tongluo tablets.Both groups were compared in terms of clinical efficacy,National Institutes of Health Stroke Scale(NIHSS)score,cerebral hemodynamic index,serum inflammatory factors,occurrence of adverse reactions and prognosis.Results The total effective rate of 94.44%in the observation group was higher than that of 76.47%in the control group,and the difference was statistically significant(P<0.05).After treatment,NIHSS score of(7.46±1.34)points in the observation group was lower than that of(9.86±2.27)points in the control group,and the difference was statistically significant(P<0.05).After treatment,the carotid artery pulsatile index(PI)in both groups was lower than that before treatment in this group,and the mean blood flow volume(Qm)and the mean blood flow velocity(Vm)were higher than those before treatment in this group;carotid artery PI of(0.64±0.08)in the observation group was lower than that of(0.79±0.11)in the control group;Qm of(5.67±0.32)L/min and Vm of(10.87±0.58)cm/s in the observation group were higher than those of(4.31±0.42)L/min and(8.99±0.74)cm/s in the control group;the differences were statistically significant(P<0.05).After treatment,the C-reactive protein(CRP)and interleukin-1β(IL-1β)in both groups were lower than those before treatment in this group;CRP and IL-1βin the observation group were lower than those in the control group;the differences were statistically significant(P<0.05).There was no statistically significant difference in incidence of adverse reactions between the two groups(P>0.05).After 3 months of treatment,there was no statistically significant difference in mortality and incidence of sequelae between the two groups(P>0.05).Conclusion Xiaoshuan Tongluo tablets combined with edaravone has better efficacy than edaravone alone in the treatment of ACI patients,and has certain advantages in improving neurological impairment,cerebral hemodynamics and inflammatory response,and has safety.