脑苷肌肽联合法舒地尔治疗急性脑梗死的临床研究

Clinical study on cattle encephalon glycoside and ignotin combined with fasudil in treatment of acute cerebral infarction

目的探讨脑苷肌肽联合法舒地尔治疗急性脑梗死的临床效果。方法选取2015年6月—2017年12月湖北省中西医结合医院收治的126例急性脑梗死患者,随机分为对照组(63例)和治疗组(63例)。对照组静脉滴注盐酸法舒地尔注射液,60 mg加入0.9%氯化钠溶液250 m L,1次/d。治疗组在对照组基础上静脉滴注脑苷肌肽注射液,20 mL加入0.9%氯化钠溶液250 mL,1次/d。两组均连续治疗2周。观察两组患者临床疗效,同时比较治疗前后两组大脑中动脉血流参数、国立卫生研究院卒中量表(NIHSS)评分、氧化应激及炎性因子、特异性生化指标水平变化情况。结果治疗后,治疗组总有效率为90.5%,显著高于对照组的76.2%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组大脑中动脉平均血流速度(Vm)值、血清中谷胱甘肽过氧化物酶(GSH-Px)活性及脑源性神经营养因子(BDNF)水平均显著升高,大脑中动脉阻力指数(RI)、搏动指数(PI)值和NIHSS评分及血清丙二醛(MDA)、肿瘤坏死因子(TNF)-α、白介素(IL)-8、髓鞘碱性蛋白(MBP)、神经元特异性烯醇化酶(NSE)水平均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后治疗组上述观察指标明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论脑苷肌肽联合法舒地尔治疗急性脑梗死疗效确切,能明显改善患者局部脑血流状态,拮抗氧化应激和炎性损伤,减少神经功能缺损,改善微循环,具有一定的临床推广应用价值。

Objective To investigate the clinical effect of cattle encephalon glycoside and ignotin combined with fasudil in treatment of acute cerebral infarction. Methods Patients(126 cases) with acute cerebral infarction in Hubei Provincial Hospital of Integrated Chinese & Western Medicine from June 2015 to December 2017 were divided into control(63 cases) and treatment(63 cases) groups. Patients in the control group were iv administered with Fasudil Hydrochloride Injection, 60 mg was added into 0.9% sodium chloride solution 250 m L, once daily. Patients in the treatment group were iv administered with Cattle Encephalon Glycoside and Ignotin Injection on the basis of the control group, 20 mL added into 0.9% sodium chloride solution 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the middle cerebral artery blood flow parameters, National Institutes of Health Stroke Scale(NIHSS) score, oxidative stress and inflammatory factors, and specific biochemical markers in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the treatment group was 90.5%, which was significantly higher than 76.2% in the control group, and there were differences between two groups(P < 0.05). After treatment, Vm in middle cerebral artery, serum GSH-Px activity, and BDNF levels in two groups were all significantly increased, but middle cerebral artery RI, PI value, NIHSS score, and serum MDA, TNF-α, IL-8, MBP, and NSE levels were significantly decreased, and the difference was statistically significant in the same group(P < 0.05). And those obvervational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups(P < 0.05).Conclusion Cattle encephalon glycoside and ignotin combined with fasudil has significant clinical efficacy in treatment of in treatment of acute cerebral infarction, can significantly improve regional cerebral blood flow and antagonize oxidative stress and inflammatory injury, reduce neurological deficit, and improve microcirculation, which has a certain clinical application value.