阿加曲班联合长春西汀注射液治疗老年腔隙性脑梗死疗效及对患者微循环和血清指标的影响  

The efficacy of argatroban combined with vinpocetine injection in the treatment of elderly lacunar infarction and its influence on microcirculation and serum indexes

作　　者：王文宗 陶彦春 王娜[1] 马兴顺 WANG Wen-zong;TAO Yan-chun;WANG Na;MA Xing-shun(Yulin First Hospital,Yulin 718000,China;Beiwan Town Central Health Center,Baiyin 730600,China)

机构地区：[1]陕西省榆林市第一医院,陕西榆林718000 [2]甘肃省靖远县北湾镇中心卫生院,甘肃白银730600

出　　处：《实用医院临床杂志》2021年第1期99-102,共4页Practical Journal of Clinical Medicine

摘　　要：目的观察阿加曲班联合长春西汀注射液用于老年腔隙性脑梗死治疗效果及对患者微循环、血流流变学及神经损伤指标的影响。方法选取120例腔隙性脑梗死患者,按照随机数字表法分为治疗组和对照组各60例,两组均进行控制血糖、血压、血脂、营养脑神经等常规治疗,对照组予以长春西汀治疗,治疗组在对照组基础上联合应用阿加曲班,1个治疗周期(14 d)后,对比两组美国国立卫生研究院卒中量表(NIHSS)评分、临床疗效、甲襞微循环状态、血液流变学指标及神经元特异性烯醇化酶(NSE)、中枢神经特异性蛋白(S-100β)水平。结果治疗14 d后,治疗组NIHSS评分低于对照组,临床总有效率高于对照组(P<0.05);两组血液流变学指标血浆黏度、全血高切黏度、红细胞聚集指数,甲襞微循环检测中管袢形态、流态、袢周状态积分及NSE、S-100β水平均较治疗前下降,且治疗组上述指标均低于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论老年腔隙性脑梗死患者采用阿加曲班、长春西汀注射液联合治疗效果显著,可降低血液黏度、改善微循环、减轻神经损伤,有利于患者神经功能缺损恢复,且安全性较好。Objective To observe the treatment effects of argatroban combined with vinpocetine injection in the treatment of elderly lacunar infarction and its influence on microcirculation,hemorheology and nerve injury indexes.Methods One hundred and twenty patients with lacunar infarction were selected and divided into treatment or control group by random number table method,60 in each group.Both groups were given routine treatments to control blood glucose,blood pressure,blood lipids and nourish the brain nerves.The control group was given vinpocetine,and the treatment group was combined with argatroban on the basis of the control group.After a treatment cycle(14 days),the National Institutes of Health Stroke Scale(NIHSS),clinical efficacy,nail fold microcirculation status,hemorheology indexes and levels of neuron-specific enolase(NSE)and central nerve specific protein(S-100β)were compared between the two groups.Results After 14 days of treatment,the NIHSS score in the treatment group was lower than that in the control group,and the total clinical effective rate was higher than that in the control group(P<0.05).The hemorheology indexes such as plasma viscosity,whole blood high-shear viscosity,erythrocyte aggregation index,scores of tube loop morphology,fluidity and periloop status in nail fold microcirculation as well as levels of NSE and S-100βin the two groups were lower than those before treatment(P<0.05),and the indexes in the treatment group were lower than those in the control group(P<0.05).There were no statistically significant differences in the incidence rates of adverse reactions between the two groups(P>0.05).Conclusion Argatroban combined with vinpocetine injection has a significant treatment effect in the treatment of elderly patients with lacunar infarction.It can reduce the blood viscosity,improve the microcirculation,and relieve the nerve injury.Therefore,it is conducive to the recovery of neurological deficits and has better safety.

关 键 词：老年 腔隙性脑梗死 阿加曲班 长春西汀 微循环 神经损伤 

分 类 号：R743.3[医药卫生—神经病学与精神病学]