依达拉奉联合长春西汀注射液治疗急性脑梗死的临床效果

依达拉奉联合长春西汀注射液治疗急性脑梗死的临床效果

作者：杨育生刘振鹏黄耀忠

来源：《中国当代医药》2020年第09期

[摘要]目的探討依达拉奉联合长春西汀注射液治疗急性脑梗死（ACI）的临床效果。方法选取2018年1月～2019年3月陆丰市人民医院收治的70例ACI患者作为研究对象，按照随机数字表法将其分为对照组和观察组，每组各35例。对照组患者采用依达拉奉治疗，观察组患者在对照组的基础上加用长春西汀注射液治疗。比较两组患者的临床疗效、不良反应发生情况及治疗前后神经功能[美国国立卫生研究院卒中量表（NIHSS）]评分、炎症因子[肿瘤坏死因子-α（TNF-α）、基质金属蛋白酶-3（MMP-3）]及氧化应激[超氧化物歧化酶（SOD）、丙二醛（MDA）]水平。结果观察组患者的治疗总有效率为97.14%，高于对照组的77.14%，差异有统计学意义（P<0.05）。观察组患者治疗后的NIHSS评分为（9.61±1.80）分，低于对照组的（12.36±2.19）分，差异有统计学意义（P<0.05）。观察组患者治疗后的TNF-α、MMP-3水平分别为（72.31±15.22）、（2.63±0.62）μg/L，均低于对照组的（95.24±18.45）、

（4.11±0.89）μg/L，差异有统计学意义（P<0.05）。观察组患者治疗后的SOD水平为

（39.62±3.50）IU/ml，高于对照组的（32.81±2.17）IU/ml，MDA水平为（9.95±1.16）

μmol/L，低于对照组的（13.34±1.11）μmol/L，差异有统计学意义（P<0.05）。两组均未发生严重的不良反应。结论依达拉奉与长春西汀注射液联合治疗可有效改善ACI患者的神经功能，增强治疗效果，降低炎症因子水平，调节氧化应激反应，加快患者康复。

[关键词]急性脑梗死;依达拉奉;长春西汀注射液;炎症因子水平

[中图分类号] R743.3; ; ; ; ; [文献标识码] A; ; ; ; ; [文章编号] 1674-4721（2020）3（c）-0057-04

Clinical effect of Edaravone combined with Vinpocetine Injection in the treatment of acute cerebral infarction

YANG Yu-sheng1; ;LIU Zhen-peng1; ;HUANG Yao-zhong2

1. The Seventh Department of Internal Medicine，Lufeng People′s Hospital， Shanwei City，Guangdong Province， Lufeng; ;516500， China;

2. Department of Neurology， Citic Huizhou Hospital， Guangdong Province， Huizhou; ;516006， China

[Abstract] Objective To explore the clinical effect of Edaravone combined with Vinpocetine Injection in the treatment of acute cerebral infarction （ACI）. Methods Seventy patients with ACI treated in Lufeng People′s Hospital from January 2018 to March 2019 were selected as research subjects. They were divided into the control group and the observation group according to the random number table method， with 35 cases in each group. Patients in the control group were treated with Edaravone， and patients in the observation group were treated with Vinpocetine Injection on the basis of the control group. The clinical efficacy， incidence of adverse reactions， and neurological function （national institute of health stroke scale [NIHSS]） score， inflammatory factors （tumor necrosis factor-α [TNF-α）， and matrix metalloproteinase-3 [MMP-3]） and oxidative stress （superoxide dismutase [SOD]， malondialdehyde [MDA]） levels before and after treatment were

compared between the two groups. Results The total effective rate of treatment in the observation group was 97.14%， which was higher than 77.14% in the control group， and the difference was statistically significant （P<0.05）. The NIHSS score of patients in the observation group after treatment was （9.61±1.80） points， which was lower than that in the control group of

（12.36±2.19） points， and the difference was statistically significant （P<0.05）. The levels of TNF-α and MMP-3 in the observation group after treatment were （72.31±15.22） and

（2.63±0.62）μg/L， which were lower than those in the control group for （95.24±18.45） and （4.11±0.89）μg/L， the differences were statistically significant （P<0.05）. The SOD level in the observation group after treatment was （39.62±3.50） IU/ml， which was higher than that in the control group for （32.81±2.17） IU/ml， and the MDA level was （9.95±1.16）μmol/L， which was lower than that in the control group for （13.34±1.11）μmol/L， the differences were statistically significant （P<0.05）. No serious adverse reactions occurred in both groups. Conclusion The combination of Edaravone and Vinpocetine Injection can effectively improve the neurological function of patients with ACI， enhance the treatment effect， reduce the level of inflammatory factors， regulate the oxidative stress response and speed up the recovery of patients.

[Key words] Acute cerebral infarction; Edaravone; Vinpocetine Injection; Inflammatory factor levels

急性脑梗死（ACI）发病急、病情进展迅速，且随着病情进展，可伴随不同程度的神经功能缺失，若未及时治疗，可导致患者丧失生活能力，甚至危及生命[1]。近年来随着医学水平的提高，已有效降低该病死亡率，但整体治疗效果仍难以达到理想状态，多数患者均出现不同程度的后遗症，影响生活质量水平。ACI病发与动脉粥样硬化、血栓形成、脑供血不足等关系密切。因此，通过恢复脑部缺血区域血液灌注，预防血栓形成，可有效改善疾病[2]。有研究指出依达拉奉在ACI治疗中取得显著效果，可有效改善脑血管扩张，缓解脑水肿，保护脑组织[3]。但也有研究指出，单一应用依达拉奉虽可改善临床症状，但整体效果不够明显[4]。在此基础上，有研究指出若将依达拉奉与脑血管扩张药物联合，可进一步增强治疗效果，在保护脑组织的同时可改善脑部血液循环[5]。长春西汀注射液是一种脑血管扩张药物，可提高脑部血液灌注，阻止血小板聚集，并有效改善脑部微循环[6]。鉴于此，本研究旨在分析依达拉奉与长春西汀注射液联合治疗ACI患者的临床效果及对炎症因子水平的影响，现报道如下。

1资料与方法

1.1一般资料

取2018年1月～2019年3月陆丰市人民医院收治的70例ACI患者作为研究对象，按照随机数字表法将其分为对照组和观察组，每组各35例。对照组中，男18例，女17例;年龄48～79岁，平均（62.43±3.25）岁;发病时间18～72 h，平均（42.58±4.16）h;梗死部位：12例放射冠梗死，10例底节梗死，13例脑叶梗死。观察组中，男19例，女16例;年龄48～81岁，