吡拉西坦联合乌拉地尔对高血压脑出血患者神经功能保护的效果观察

Protective effect of piracetam combined with urapidil on neurological function in patients with hypertensive intracerebral hemorrhage

目的:研究吡拉西坦联合乌拉地尔对高血压脑出血患者神经功能保护的效果。方法:回顾性分析2020年1月至2023年3月期间本院收治的68例高血压脑出血患者临床资料。根据不同治疗方案将患者分为对照组和研究组,每组各34例。对照组给予乌拉地尔治疗12.5 mg静脉推注,研究组在对照组基础上增加吡拉西坦片1.6 g tid口服治疗。分析比较两组治疗2 w后的临床疗效、不良反应,分别采用卒中量表(National institute of health stroke scale,NIHSS)、日常生活活动能力量表(Activities of daily living scale,ADL)、简易精神状态评价量表(Mini-mental state examination,MMSE)评估治疗前、治疗2 w后临床相关评分水平,采用CT仪检测血肿体积、脑水肿带体积水平,采用酶联免疫法检测细胞因子白细胞介素-6(Interleukin-6,IL-6)、神经轴突生长抑制因子A(Neurite outgrowth inhibitor A,Nogo-A)、C反应蛋白(C-reactive protein,CRP)水平。结果:研究组的临床疗效较对照组显著提高(P<0.05)。与治疗前相比,两组ADL、MMSE评分均明显升高,NIHSS评分显著降低,其中研究组改善幅度更为显著(P<0.05)。与治疗前相比,两组血肿体积、脑水肿带体积均明显降低,其中研究组降低幅度更为显著(P<0.05)。与治疗前相比,两组Nogo-A、IL-6、CRP水平均明显降低,其中研究组降低幅度更为显著(P<0.05)。两组的不良反应发生率无显著差异(P>0.05)。结论:吡拉西坦联合乌拉地尔治疗能抑制高血压脑出血患者炎性因子表达,保护神经功能,提升生活能力,促进病情缓解。

Objective:To study the protective effect of piracetam combined with urapidil on nerve function in patients with hypertensive cerebral hemorrhage.Methods:Retrospective analysis of clinical data of 68 patients with hypertensive cerebral hemorrhage admitted to our hospital from January 2020 to March 2023.Patients were divided into a control group and a study group according to different treatment plans,with 34 patients in each group.The control group received intravenous injection of urapidil 12.5 mg,while the study group received oral administration of piracetam tablets 1.6 g tid in addition to the control group.The clinical efficacy and adverse reactions were analyzed and compared after 2 weeks of treatment.The National Institute of Health Stroke Scale(NIHSS),Activities of Daily Living Scale(ADL),and Mini-mental state examination(MMSE)were used to assess the clinical scores before and after treatment.The volume of hematoma and brain edema was measured using CT,and the levels of cytokines interleukin-6(IL-6),neurite outgrowth inhibitor A(Nogo-A),and C-reactive protein(CRP)were detected using enzyme-linked immunosorbent assay.Results:The clinical efficacy of the study group was significantly improved compared to the control group(P<0.05).Compared to before treatment,both groups showed significant improvements in ADL and MMSE scores,with a substantial decrease in NIHSS scores,with the study group showing a more significant improvement(P<0.05).Compared to before treatment,both groups showed significant reductions in hematoma volume and brain edema volume,with the study group showing a more significant reduction(P<0.05).Compared to before treatment,both groups showed significant reductions in Nogo-A,IL-6,and CRP levels,with the study group showing a more significant reduction(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Piracetam combined with urapidil can inhibit the expression of inflammatory factors in patients with hypertensive cerebral hemorrhage,protect neural function,improve living ability,and promote disease remission.