胞磷胆碱联合阿替普酶治疗急性脑梗死的疗效及对脑血流速度和炎症因子的影响

Efficacy of Citicoline Combined with Alteplase in the Treatment of Acute Cerebral Infarction and Its Effect on Cerebral Blood Flow Velocity and Inflammatory Factors

目的:探讨胞磷胆碱联合阿替普酶治疗急性脑梗死(acute cerebral infarction,ACI)的疗效及对脑血流速度和炎症因子的影响。方法:ACI患者60例使用随机数表法分为对照组与试验组,每组30例。两组均予以抗血小板聚集、抗凝等常规治疗;此外,对照组予以阿替普酶溶栓治疗,观察组胞磷胆碱联合阿替普酶治疗,两组均治疗14 d。对两组治疗前和治疗后的神经功能(美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS))、日常生活能力(Barthel指数(Barthel index,BI))、脑血流速度和血清炎症因子(C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α))等进行统计分析,对比两组疗效和不良反应。结果:与对照组(73.33%)进行比较,观察组总有效率(96.67%)更高(P<0.05)。治疗后,相比对照组,观察组NIHSS评分更低(P<0.05),BI评分更高(P<0.05)。治疗后,观察组脑血流速度提高(P<0.05),血清CRP、TNF-α水平降低(P<0.05)。两组不良反应发生率不具有统计学差异(P>0.05)。结论:胞磷胆碱联合阿替普酶治疗ACI疗效显著,能够更好地减轻患者神经功能缺损,其机制可能与改善脑血流速度和降低炎症水平有关。

Objective:To investigate the efficacy of citicoline combined with alteplase in the treatment of acute cerebral infarction(ACI)and its effect on cerebral blood flow velocity and inflammatory factors.Methods:Sixty patients with ACI were divided into control group and experimental group by random number table method,with 30o cases in each group.Both groups were given conventional treatment such as anti-platelet aggregation and anticoagula-tion.In addition,the control group was treated with alteplase thrombolytic therapy,and the observation group was treated with citicoline combined with alteplase.Both groups were treated for l4 days.The neurological function(National Institutes of Health Stroke Scale(NIHSS)),daily living ability(Barthel Index(BI)),cerebral blood flow velocity and serum inflammatory factors(C-reactive protein(CRP),tumor necrosis factor-α(TNF-α))of the two groups before and after treatment were statistically analyzed,and the efficacy and adverse reactions of the two groups were compared.Results:Compared with the control group(73.33%),the total effective rate of the observation group(96.67%)was higher(P<0.05).After treatment,compared with the control group,the NIHSS score of the observation group was lower(P<0.05),and the BI score was higher(P<0.05).After treatment,the cerebral blood flow velocity in the observation group was increased(P<0.05),and the levels of serum CRP and TNF-αwere decreased(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Citicoline combined with alteplase is effective in the treatment of ACI,which can better reduce the neurological deficit of patients.The mechanism may be related to the improvement of cere-bral blood flow velocity and the reduction of inflammation level.