胞磷胆碱对大脑中动脉缺血性脑卒中恢复期的疗效  

Effect of citicoline on the recovery period of middle cerebral artery ischemic stroke

作　　者：胡飞龙[1] 路璐[1] Feilong Hu;Lu Lu(Department of Geriatrics,Bozhou People's Hospital,Bozhou 236800,China)

机构地区：[1]亳州市人民医院老年医学科,安徽亳州236800

出　　处：《中华脑科疾病与康复杂志（电子版）》2023年第1期51-56,共6页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

摘　　要：目的探究胞磷胆碱联合常规西药对大脑中动脉缺血性脑卒中恢复期患者的治疗效果及对脑血流变化的影响。方法选取自2018年7月至2021年12月亳州市人民医院老年医学科收治的134例大脑中动脉缺血性脑卒中恢复期患者,按照随机数字表法分为试验组和常规组,每组67例。2组患者均服用西药(阿司匹林肠溶片、丁苯酞软胶囊)、实施常规康复训练及控制血压、血糖、血脂等,试验组在常规组基础上增加胞磷胆碱。对比2组患者治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、大脑中动脉脑血流参数[平均脑血流速度(Vm)、脑血流量(CBF)、搏动指数(PI)、阻力指数(RI)]、血清炎性因子水平[白介素-6(IL-6)、单核细胞趋化蛋白-1(MCP-1)、超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)],临床疗效和不良反应发生率。结果治疗后2组患者NIHSS评分、大脑中动脉PI与RI以及血清IL-6、MCP-1、hs-CRP、TNF-α水平均低于治疗前,大脑中动脉Vm、CBF均高于治疗前,差异具有统计学意义(P<0.05);治疗后试验组NIHSS评分、大脑中动脉PI与RI以及血清IL-6、MCP-1、hs-CRP、TNF-α水平均低于常规组,大脑中动脉Vm、CBF均高于常规组,差异具有统计学意义(P<0.05)。试验组NIHSS评分、大脑中动脉脑血流参数(Vm、CBF、PI、RI)和血清炎性因子(IL-6、MCP-1、hs-CRP、TNF-α)水平的治疗前后差值大于常规组,差异具有统计学意义(P<0.05)。试验组总有效率(94.03%)高于常规组(82.09%),差异具有统计学意义(P<0.05)。2组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论对大脑中动脉缺血性脑卒中恢复期患者采用胞磷胆碱联合其他西药进行治疗能降低神经功能缺损评分与炎性因子水平,并可改善大脑中动脉脑血流,提升临床疗效,且安全性好。Objective To explore the efficacy of citicoline combined with conventional western medicine in convalescence patients with middle cerebral artery ischemic stroke and its influence on cerebral blood flow.Methods One hundred and thirty-four conventional patients with middle cerebral artery ischemic stroke from July 2018 to December 2021 admitted in Geriatrics Department of Bozhou People's Hospital were selected,and they were divided into the experimental group and the conventional group through the random number table,with 67 cases in each group.Both groups were given western medicine(aspirin enteric-coated tablets,butylphthalide soft capsules),carried out routine rehabilitation training and controlled blood pressure,blood glucose and blood lipid,while citicoline were added to the experimental group on the basis of the conventional group.The National Institute of Health stroke scale(NIHSS)scores,the changes of cerebral blood flow parameters of middle cerebral artery[mean cerebral blood flow velocity(Vm),mean cerebral blood flow(CBF),pulsatility index(PI),resistance index(RI)]and the levels of serum inflammatory factors[interleukin-6(IL-6),monocyte chemoattractant protein-1(MCP-1),high sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)]before and after treatment,clinical efficacy and the incidences of adverse reactions were compared between the two groups.Results After treatment,the NIHSS scores,PI and RI of middle cerebral artery and the levels of serum IL-6,MCP-1,hs-CRP and TNF-αof the two groups were lower than those before treatment,but the Vm and CBF of middle cerebral artery were higher than those before treatment(P<0.05).After treatment,the NIHSS score,PI and RI of middle cerebral artery and the levels of serum IL-6,MCP-1,hs-CRP and TNF-αin the experimental group were lower than those in the conventional group(P<0.05),but the Vm and CBF of middle cerebral artery were higher than those in the conventional group(P<0.05).The D-values before and after treatment of the NIHSS score,blood flow

关 键 词：大脑中动脉 缺血性脑卒中 恢复期 胞磷胆碱 脑血流 炎性因子 

分 类 号：R743.3[医药卫生—神经病学与精神病学]