摘要
目的探讨乌拉地尔注射液联合奥拉西坦治疗急性脑出血患者的临床疗效。方法采用回顾性研究的方法。将濮阳市安阳地区医院2021年8月至2024年8月收治的116例急性脑出血患者按治疗方法分为对照组(奥拉西坦治疗)与联合组(奥拉西坦联合乌拉地尔注射液治疗),各58例。两组均连续治疗2周。比较两组的神经功能、脑血肿及脑水肿体积、氧化应激指标、炎症因子以及不良反应情况。结果两组治疗后的美国国立卫生研究院卒中量表(NIHSS)评分较治疗前下降,格拉斯哥昏迷量表(GCS)评分较治疗前上升,且联合组的NIHSS评分、GCS评分[分别为(9.56±1.92)分、(13.02±1.84)分]均优于对照组[分别为(12.94±2.87)分、(10.23±1.56)分](t=7.455、8.808,均P<0.05)。两组治疗后的脑血肿及脑水肿体积均较治疗前下降,且联合组脑血肿及脑水肿体积[分别为(9.32±2.85)mL、(8.89±1.95)mL]均低于对照组[分别为(12.45±2.67)mL、(13.06±3.12)mL](t=6.104、8.632,均P<0.05)。两组治疗后的丙二醛(MDA)水平较治疗前下降,超氧化物歧化酶(SOD)较治疗前上升,且联合组的MDA水平(3.56±0.95)μmol·L^(-1)低于对照组(4.12±0.98)μmol·L^(-1),SOD水平(107.56±7.45)U·mL^(-1)高于对照组(91.24±8.12)U·mL^(-1)(t=3.125、11.279,均P<0.05)。两组治疗后的肿瘤坏死因子α(TNF-α)、超敏C反应蛋白(hs-CRP)水平均较治疗前下降,且联合组TNF-α、hs-CRP水平[分别为(34.72±6.13)pg·mL^(-1)、(3.64±0.65)mg·L^(-1)]均低于对照组[分别为(42.36±5.86)pg·mL^(-1)、(4.52±0.69)mg·L^(-1)](t=6.861、7.070,均P<0.05)。联合组和对照组不良反应发生率分别为6.90%、12.07%,差异无统计学意义(χ^(2)=0.940,P>0.05)。结论乌拉地尔注射液联合奥拉西坦治疗急性脑出血患者具有良好的疗效,可改善患者的神经功能、加速血肿吸收、减轻氧化应激及炎症反应,且安全性良好。
Objective To investigate the clinical efficacy of urapidil injection combined with oxiracetam in the treatment of patients with acute cerebral hemorrhage.Methods A retrospective study method was employed.A total of 116 patients with acute cerebral hemorrhage admitted to Anyang District Hospital in Puyang city from August 2021 to August 2024 were divided into the control group(treated with oxiracetam alone)and the observation group(treated with oxiracetam combined with urapidil injection)according to the treatment methods,with 58 cases in each group.Both groups underwent continuous treatment for 2 weeks.The neurological functions,the volumes of cerebral hematoma and cerebral edema,oxidative stress indicators,inflammatory factors and adverse reactions were compared between the two groups.Results After treatment,the National Institutes of Health Stroke Scale(NIHSS)scores decreased and the Glasgow Coma Scale(GCS)scores increased in both groups compared with those before treatment,and the NIHSS score and GCS score in the observation group((9.56±1.92)points,(13.02±1.84)points,respectively)were both better than those in the control group((12.94±2.87)points,(10.23±1.56)points,respectively)(t=7.455,8.808,both P<0.05).After treatment,the volumes of cerebral hematoma and cerebral edema in both groups decreased compared with those before treatment,and the observation group showed lower volumes of cerebral hematoma and cerebral edema((9.32±2.85)mL,(8.89±1.95)mL,respectively)compared with those of the control group((12.45±2.67)mL,(13.06±3.12)mL,respectively)(t=6.104,8.632,both P<0.05).After treatment,malondialdehyde(MDA)levels decreased and superoxide dismutase(SOD)levels increased in both groups compared with pre-treatment levels,and the observation group exhibited lower MDA levels((3.56±0.95)μmol·L^(-1))and higher SOD levels((107.56±7.45)U·mL^(-1))compared with those of the control group((4.12±0.98)μmol·L^(-1) and(91.24±8.12)U·mL^(-1),respectively)(t=3.125,11.279,both P<0.05).After treatment,the levels of tumor necrosis factor-α(TNF-α)and high-sensitivity C-reactive protein(hs-CRP)decreased in both groups compared with pre-treatment levels,and the observation group had lower levels of TNF-αand hs-CRP((34.72±6.13)pg·mL^(-1),(3.64±0.65)mg·L^(-1),respectively)compared with those of the control group((42.36±5.86)pg·mL^(-1),(4.52±0.69)mg·L^(-1),respectively)(t=6.861,7.070,both P<0.05).The incidence of adverse reactions in the observation group and the control group was 6.90%and 12.07%respectively,with no statistically significant difference(χ^(2)=0.940,P>0.05).Conclusion The combination of urapidil injection and oxiracetam in the treatment of patients with acute cerebral hemorrhage demonstrates good efficacy,improving neurological function,accelerating hematoma absorption,alleviating oxidative stress and inflammatory responses,with favorable safety.
作者
李俊青
洪丽
牛艳国
Li Junqing;Hong Li;Niu Yanguo(Department of Neurology,Anyang District Hospital,Anyang 455000,China)
出处
《中国药物应用与监测》
2025年第5期778-782,共5页
Chinese Journal of Drug Application and Monitoring
关键词
乌拉地尔
奥拉西坦
急性脑出血
血肿
氧化应激
神经功能
Urapidil
Oxiracetam
Acute cerebral hemorrhage
Hematoma
Oxidative stress
Neurological function
