依达拉奉联合奥扎格雷钠对急性脑梗死患者神经功能缺损的影响

目的 观察依达拉奉联合奥扎格雷钠治疗急性脑梗死(ACI)的疗效.方法 将82例ACI患者随机分为两组,每组41例,对照组给予奥扎格雷钠静脉滴注治疗,85 mg/次,2次/d;观察组在对照组治疗基础上加依达拉奉静脉滴注,30 mg/次,2次/d,持续治疗4周.治疗前后均采用美国国立卫生院卒中量表(NIHSS)评价患者神经功能缺损改善情况,采用彩超检测双侧大脑中动脉血流情况,并检测血清神经元特异性烯醇化酶(NSE)、基质金属蛋白酶9(MMP-9)及高迁移率族蛋白B1(HMGB1)变化.结果 两组治疗后大脑中动脉血流速度(Vm)、收缩期峰值流速(PSV)、舒张末期血流速度(EDV)、阻力指数(RI)、搏动指数(PI)较治疗前均显著改善,但组间比较差异无统计学意义(P＞0.05).治疗后观察组NIHSS评分为(4.38±0.82),低于对照组的(5.52±1.02)(P＜0.05).治疗后观察组NSE、MMP-9、HMGB1浓度分别为(10.16±2.82) μg/L、(77.58±5.82) ng/ml、(2.69±0.37)ng/L,低于对照组的(11.83±3.23)μg/L,、(81.26±6.22) ng/ml、(3.56±0.52) ng/L(均P＜ 0.05).Spearman相关性分析显示NSE、MMP-9、HMGB1浓度与NIHSS评分呈正相关(r=1.04,0.75,0.62;P＜ 0.05).结论 奥扎格雷钠可改善ACI患者脑中动脉血流,而依达拉奉可促进血清细胞因子的清除,二者联合使用可促进患者神经功能恢复.

Effect of edaravone combined with ozagrel on neurological function defect in patients with acute cerebral infarction

Objective To observe effect of edaravone combined with ozagrel in the treatment of patients with acute cerebral infarction (ACI).Methods 82 patients with ACI were randomly divided into two groups,41 cases in each group.Control group was treated with ozagrel intravenous drip,85 mg/times,bid;and observation group was treated with edaravone on the basis of control group,30 mg/times,bid,continued treated for 4 weeks.Evaluated neurological function defect with NIHSS,detected bilateral brain arterial blood flow with color Doppler ultrasound,and detected serum NSE,MMP-9,HMGB1.Results After treatment,Vm,PSV,EDV,RI,PI in two groups significantly improved,but without statistically significant differences between two groups (P＞0.05).NIHSS score in observation group after treatment was (4.38±0.82),lower than (5.52±1.02) in control group (P＜0.05).NSE,MMP-9,HMGB1 concentration in observation group were (10.16±2.82)μg/L,(77.58±5.82) ng/ml,(2.69-±0.37) ng/L,lower than (11.83±3.23)μg/L,(81.26±6.22) ng/ml,(3.56±0.52) ng/L in control group (all P＜0.05).Spearman correlation analysis showed that NSE,MMP-9,HMGB1 concentration were positively correlated with NIHSS score (r=1.04,0.75,0.62;P＜0.05).Conclusion Ozagrel can improve blood flow in the brain arteries of patients with ACI,and edaravone can promote clearance of serum cytokines,both can promote recovery of neurological function in patients.