目的 探讨血栓通注射液联合奥拉西坦对老年缺血性脑卒中(ischemic stroke，IS)的作用。方法 选取106例老年IS患者作为研究对象，随机分为观察组和对照组，每组53例。对照组用奥拉西坦治疗，观察组在对照组治疗的基础上联合血栓通注射液治疗，比较2组的临床疗效、神经功能[用美国国立卫生研究院卒中量表评分(national institute of health stroke scale，NIHSS)评估]、运动功能(用日常生活活动能力(activities of daily living，ADL)量表评估)、颈动脉狭窄程度(颈动脉内中膜厚度和狭窄率)、血流动力学(全血黏度、血流速度和血流阻力)、神经损伤因子[神经胶质原纤维酸性蛋白(glial fibrillary acidic protein，GFAP)、神经元特异性烯醇化酶(neuron-specific enolase，NSE)和脑源性神经生长因子(brain-derived neurotrophic factor，BDNF)]和氧化应激指标[丙二醛(malondialdehyde，MDA)和超氧化物歧化酶(superoxide dismutase，SOD)]水平。结果 观察组的总有效率为98。11%，高于对照组的86。79%(P<0。05);治疗后，观察组的NIHSS评分为(10。14±1。91)分，低于对照组的(12。43±2。12)分，P<0。05;观察组的ADL评分为(64。49±8。30)分，高于对照组的(58。37±7。26)分，P<0。05;观察组颈动脉内中膜厚度和狭窄率分别为(1。27±0。11)mm、(74。84%±5。14%)，低于对照组[(1。33±0。13)mm、(78。92%±5。95%)]，P<0。05;观察组(高切和低切)全血黏度和血流阻力分别为(4。72±0。91)mPa·s、(10。99±2。25)mPa·s、(1。52±0。24)Pa·s·L-1，低于对照组[(5。86±1。17)mPa·s、(13。40±2。77)mPa·s、(1。64±0。27)Pa·s·L-1]，血流速度为(18。33±3。85)cm·s-1，高于对照组[(16。51±3。61)cm·s-1]，P<0。05;观察组的GFAP和NSE分别为(5。62±1。11)、(23。88±4。25)ng∙mL-1，低于对照组[(6。57±1。30)、(27。17±4。76)ng∙mL-1]，BDNF为(3。06±0。77)ng∙mL-1，高于对照组[(2。38±0。52)ng·mL-1]，P<0。05;观察组的MDA为(3。62±0。63)μmol·L-1，低于对照组[(4。05±0。78)μmol·L-1]，SOD为(105。20±15。63)U·mL-1，高于对照组[(93。42±13。27)U·mL-1]，P<0。05。结论 血栓通注射液联合奥拉西坦对老年IS患者疗效显著，可通过调节神经损伤因子和氧化应激因子水平及改善血流动力学，提高患者的神经功能和运动功能，改善颈动脉狭窄。
Effects of Xueshuantong Injections combined with oxiracetam on elderly ischemic stroke
Objective To explore the effects of Xueshuantong Injections combined with oxiracetam on elderly ischemic stroke(IS).Methods A total of 106 elderly patients with IS were enrolled as the research objects.They were randomly divided into observation group and control group,53 cases in each group.The control group was treated with oxiracetam,while the observation group was additionally treated with Xueshuantong Injections.The clinical curative effect,nerve function[national institutes of health stroke scale(NIHSS)],motor function[activity of daily living scale(ADL)],carotid stenosis(intima-media thickness,and carotid stenosis rate),hemodynamics(whole blood viscosity,blood flow velocity,and blood flow resistance),nerve injury factors[glial fibrilinic acid protein(GFAP),neuron-specific enolase(NSE),and brain-derived neurotrophic factor(BDNF)]and oxidative stress indexes[malondialdehyde(MDA),and superoxide dismutase(SOD)]were compared between the 2 groups.Results The total response rate of observation group was higher than that of control group(98.11%vs.86.79%,P<0.05).After treatment,the NIHSS score in observation group was lower than that in control group[(10.14±1.91)points vs.(12.43±2.12)points,P<0.05].The ADL score in observation group was higher than that in control group[(64.49±8.30)points vs.(58.37±7.26)points,P<0.05].The carotid intima-media thickness and stenosis rate in observation group were(1.27±0.11)mm and(74.84%±5.14%),lower than those in control group[(1.33±0.13)mm and(78.92%±5.95%),P<0.05].The high-shear and low-shear whole blood viscosity,and blood flow resistance in observation group were(4.72±0.91)mPa·s,(10.99±2.25)mPa·s and(1.52±0.24)Pa·s·L-1,lower than those in control group[(5.86±1.17)mPa·s,(13.40±2.77)mPa∙s,(1.64±0.27)Pa·s·L-1],while the blood flow velocity was faster than that in control group[(18.33±3.85)cm·s-1 vs.(16.51±3.61)cm·s-1,P<0.05].The levels of GFAP and NSE in observation group were(5.62±1.11)and(23.88±4.25)ng·mL-1,lower than those in control group[(6.57±1.30)and(27.17±4.76)ng∙mL-1],while the BDNF was higher than that in control group[(3.06±0.77)ng·mL-1 vs.(2.38±0.52)ng∙mL-1,P<0.05].the MDA in observation group was lower than that in control group[(3.62±0.63)μmol·L-1 vs.(4.05±0.78)μmol·L-1],while the SOD was higher than that in control group[(105.20±15.63)U·mL-1 vs.(93.42±13.27)U·mL-1,P<0.05].Conclusion The curative effect of Xueshuantong Injections combined with oxiracetam is significant in elderly patients with IS,which can improve hemodynamics,nerve function,motor function and carotid stenosis by regulating levels of nerve injury and oxidative stress factors.
Xueshuantong Injectionsoxiracetamischemic strokenerve functionseverity of carotid stenosishemodynamics
NETL
NSTL
万方数据
维普
