摘要
目的探讨己酮可可碱与依达拉奉右莰醇联合治疗急性脑梗死(ACI)的疗效及对血清同型半胱氨酸(Hcy)、脂蛋白相关磷脂酶A2(Lp-PLA2)水平的影响。方法选择2022年8月至2024年10月河南科技大学第一附属医院予以救治的ACI患者共82例为此次试验对象,使用标准随机数字表法分成两组。两组均给予规范的静脉溶栓治疗,对照组41例患者给予依达拉奉右莰醇治疗,观察组41例患者给予己酮可可碱与依达拉奉右莰醇联合治疗,均治疗2周。对比两组患者的治疗效果,同时于治疗前后分别检测两组患者血清Hcy、Lp-PLA2水平。结果在总有效率方面,观察组为92.68%(38/41),高于对照组的75.61%(31/41)(χ^(2)=4.479,P=0.034)。治疗后,观察组美国国立卫生院卒中量表(NIHSS)评分[(5.75±1.60)分]较对照组低[(8.12±1.88)分](t=6.147,P<0.05),日常生活活动能力量表(ADL)评分[(83.35±8.92)分]较对照组高[(69.08±8.42)分](t=6.147、-7.449,均P<0.05)。治疗后,观察组两侧大脑中动脉的峰流速(Vp)、平均流速(Vm)[(71.58±1.72)cm·s^(-1)、(18.65±1.99)cm·s^(-1)]均高于对照组[(64.24±1.93)cm·s^(-1)、(14.13±1.38)cm·s^(-1)](t=-18.180、-11.951,均P<0.05)。治疗后,观察组Hcy、Lp-PLA2水平[(22.58±2.16)cm·s^(-1)、(41.07±7.08)μg·L^(-1)]均低于对照组[(28.72±2.08)cm·s^(-1)、(55.65±6.92)μg·L^(-1)](t=13.111、9.430,均P<0.05)。在不良反应发生概率方面,对照组为12.20%(5/41),观察组为17.07%(7/41),两组比较差异无统计学意义(χ^(2)=0.390,P>0.05)。结论依达拉奉右莰醇与己酮可可碱联合治疗ACI具有确切的临床疗效,可促进患者的神经功能恢复并提升日常生活能力,下调血清Hcy、Lp-PLA2水平,且安全性良好。
Objective To explore the clinical efficacy of pentoxifylline combined with edaravone and dexborneol in the treatment of acute cerebral infarction(ACI)and its effects on the levels of serum homocysteine(Hcy)and lipoprotein-associated phospholipase A2(Lp-PLA2).Methods A total of 82 patients with ACI admitted to the First Affiliated Hospital of Henan University of Science&Technology from August 2022 to October 2024 were selected and randomly divided into two groups using the standard random number table method.Both groups received standardized intravenous thrombolysis therapy.41 patients in the control group were treated with edaravone and dexborneol alone,while 41 patients in the observation group were treated with the combination of pentoxifylline and edaravone and dexborneol.Both groups were treated for 2 weeks.The therapeutic effects of the two groups were compared,and the levels of serum Hcy and Lp-PLA2 of the two groups of patients before and after treatment were measured.Results The total effective rate of the observation group was 92.68%(38/41),which was higher than that of the control group(75.61%(38/41))(χ^(2)=4.479,P=0.034).After treatment,the score of the National Institutes of Health Stroke Scale(NIHSS)in the observation group((5.75±1.60)points)was lower than that in the control group((8.12±1.88)points)(t=6.147,P<0.05),and the score of the Activities of Daily Living Scale(ADL)in the observation group((83.35±8.92)points)was higher than that in the control group((69.08±8.42)points)(t=-7.449,P<0.05).After treatment,the peak velocity(Vp)and mean flow velocity(Vm)of the middle cerebral arteries on both sides in the observation group((71.58±1.72)cm·s^(-1),(18.65±1.99)cm·s^(-1))were higher than those of the control group((64.24±1.93)cm·s^(-1),(14.13±1.38)cm·s^(-1))(t=-18.180,-11.951,both P<0.05).After treatment,the levels of Hcy and Lp-PLA2 in the observation group((22.58±2.16)cm·s^(-1),(41.07±7.08)μg·L^(-1))were lower than those in the control group((28.72±2.08)cm·s^(-1),(55.65±6.92)μg·L^(-1))(t=13.111,9.430,both P<0.05).The incidence of adverse reactions in the control group was 12.20%(5/41),and the observation group was 17.07%(7/41),and there was no statistically significant difference between the two groups(χ^(2)=0.390,P>0.05).Conclusion The combination of pentoxifylline and edaravone and dexborneol in the treatment of patients with ACI has definite clinical efficacy,which can promote the recovery of neurological function and improve the ability of daily living of patients,down-regulate the levels of serum Hcy and Lp-PLA2,and has good safety.
作者
张笑娜
高涛
王亚杰
Zhang Xiaona;Gao Tao;Wang Yajie(Department of Neurology,The First Affiliated Hospital of Henan University of Science&Technology,Luoyang 471000,China)
出处
《中国药物应用与监测》
2025年第5期783-786,共4页
Chinese Journal of Drug Application and Monitoring
