吡拉西坦联合重组人组织型纤溶酶原激活剂静脉溶栓治疗急性脑梗死的临床效果  

Clinical Effect of Piracetam Combined with Intravenous Thrombolysis of Recombinant Human Tissue Plasminogen Activator on Acute Cerebral Infarction

作　　者：朱珊珊 于怀芳 ZHU Shanshan;YU Huaifang(Department of Neurology,General Hospital,Zhengzhou Coal Industry(Group)Co.,LTD.,Zhengzhou 452370,China)

机构地区：[1]郑州煤炭工业(集团)有限责任公司总医院神经内科,河南郑州452370

出　　处：《河南医学研究》2022年第13期2427-2430,共4页Henan Medical Research

摘　　要：目的探讨急性脑梗死(ACI)患者应用吡拉西坦联合重组人组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗的临床效果。方法选取2018年8月至2021年1月郑州煤炭工业(集团)有限责任公司总医院收治的64例ACI患者,再利用计算机生成的随机数表将64例ACI患者分为两组,每组32例。给予对照组患者rt-PA静脉溶栓联合常规治疗,观察组于对照组基础上加用吡拉西坦治疗,治疗2周。采用中文版美国国立卫生研究院卒中量表(NIHSS)评估两组患者治疗前后的神经功能。比较两组治疗前后脑血流动力学(平均血流速度、平均血流量、脑血管外周阻力)、氧化应激指标,包括丙二醛(MDA)、超氧化物歧化酶(SOD)水平。比较两组不良反应发生率。结果两组治疗2周后的NIHSS评分呈降低趋势,且观察组NIHSS评分低于对照组(P<0.05)。两组治疗2周后的平均血流速度及平均血流量呈升高趋势,脑血管外周阻力呈降低趋势(P<0.05);与对照组比较,观察组平均血流速度及平均血流量较大,脑血管外周阻力较小(P<0.05)。治疗2周,两组MDA水平降低,SOD水平上升(P<0.05);治疗2周,观察组MDA水平比对照组低,SOD水平比对照组高(P<0.05)。两组治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论ACI患者应用吡拉西坦与rt-PA静脉溶栓联合治疗可改善脑血流动力学,缓解氧化应激反应,促进神经功能恢复。Objective To explore the clinical effect of piracetam combined with intravenous thrombolysis of recombinant human tissue plasminogen activator(rt-PA)in patients with acute cerebral infarction(ACI).Methods A total of 64 patients with ACI treated in the General Hospital,Zhengzhou Coal Industry(Group)Co.,LTD.from August 2018 to January 2021 were selected.They were divided into 2 groups with 32 cases in each group by computer-generated random number table.The patients in control group were given rt-PA intravenous thrombolysis combined with routine treatment,while the patients in observation group were treated with piracetam on the basis of control group.Both of them were treated for 2 weeks.The Chinese version of National Institutes of Health stroke scale(NIHSS)was used to evaluate the neurological function of patients in the two groups before and after treatment.Before and after treatment,cerebral hemodynamics(average blood flow velocity,average blood flow,cerebrovascular peripheral resistance)and oxidative stress indexes,including malondialdehyde(MDA)and superoxide dismutase(SOD)levels were compared between the two groups.The incidence of adverse reactions was compared between the two groups.Results After 2 weeks of treatment,the NIHSS scores of both groups showed a decreasing trend,and the score of NIHSS in observation group was lower than that in control group(P<0.05).After 2 weeks of treatment,the average blood flow velocity and blood flow in both groups showed an increasing trend,and the peripheral resistance of cerebral vessels showed a decreasing trend(P<0.05).Compared with control group,the average blood flow velocity and blood flow in observation group were larger,and the peripheral resistance of cerebral vessels was smaller(P<0.05).After 2 weeks of treatment,the levels of MDA decreased and the levels of SOD were increased in both groups(P<0.05).After 2 weeks of treatment,the level of MDA in observation group was lower than that in control group,and the level of SOD was higher than that in control group(P<0

关 键 词：急性脑梗死 吡拉西坦 重组人组织型纤溶酶原激活剂 神经功能 血流动力学 氧化应激 

分 类 号：R743.3[医药卫生—神经病学与精神病学]