尼麦角林联合神经节苷脂钠对缺血性脑卒中患者凝血功能和神经递质的影响  

Effects of nimergoline combined with ganglioside sodium on coagulation function and neurotransmitters in patients with cerebral ischemic stroke

作　　者：张书艳 柳文科 杨猛 ZHANG Shuyan;LIU Wenke;YANG Meng(Department of Neurology,No.990 Hospital of PLA Joint Logistic Support Force,Xinyang(464000),Henan,China)

机构地区：[1]信阳一五四医院神经内科,河南信阳464000

出　　处：《癫痫与神经电生理学杂志》2024年第2期91-96,共6页Journal of Epileptology and Electroneurophysiology(China)

基　　金：河南省医学科技攻关联合共建项目(LHGJ20211023)。

摘　　要：目的探讨尼麦角林联合神经节苷脂钠对缺血性脑卒中(CIS)患者凝血功能和血清神经递质水平的影响。方法选取2021年1月至2023年8月中国人民解放军联勤保障部队第九九〇医院神经内科收治的CIS患者104例,根据治疗方案不同分为尼麦角林单药治疗组(52例)和尼麦角林联合神经节苷脂钠联合药物治疗组(52例),两组患者均连续治疗14 d。比较两组患者的治疗总有效率、神经功能、生活质量、凝血功能、神经递质及不良反应等。结果经治疗后联合药物治疗组的总有效率较单药治疗组高,差异有统计学意义(P<0.05);治疗14 d后,两组患者的美国国立卫生研究院卒中评估量表(NIHSS)评分均较治疗前降低,日常生活能力评估量表(ADL)评分均较治疗前升高,其中联合药物治疗组改善更为明显,差异有统计学意义(P<0.05);治疗14 d后,两组患者的凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、凝血酶时间(TT)均较治疗前升高,纤维蛋白原(FIB)较治疗前降低,且联合药物治疗组的改善幅度更大,差异有统计学意义(P<0.05);治疗14 d后,两组患者的血清脑源性神经营养因子(BDNF)及神经生长因子(NGF)水平均较治疗前升高,神经生长相关蛋白-43(GAP-43)、髓磷脂碱性蛋白(MBP)较治疗前降低,但联合药物治疗组改善更为明显,差异有统计学意义(P<0.05);两组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。结论尼麦角林与神经节苷脂钠联合运用能增强疗效,可进一步改善CIS患者的神经功能及凝血功能,提升患者的生活质量,其机制可能与调节神经递质表达有关。Objective To investigate the effects of nicergoline combined with ganglioside sodium on coagulation function and serum neurotransmitter levels in patients with cerebral ischemic stroke(CIS).Methods A total of 104 patients with CIS were selected from the department of Neurology,the No.990 Hospital of PLA Joint Logistics Support Force from January 2021 to August 2023.According to treatment regimen,the patients were divided into monotherapy group(Niergoline,52 cases)and combination group(Niergoline+ganglioside sodium,52 cases).Both groups were treated continuously for 14 days.Total therapeutic effective rate,neurological function,quality of life,coagulation function,neurotransmitters and adverse reactions of treatment were compared between two groups of the patients.Results After treatment,the total therapeutic effective rate of combination group was higher than that of monotherapy group(P<0.05).After 14 days of treatment,the National Institutes of Health Stroke Scale(NIHSS)scores of both groups of patients were decreased when compared to before treatment,and the Activities of Daily Living(ADL)scores were increased when compared to before treatment.The improvement was more obvious in combination group(P<0.05).After 14 days of treatment,prothrombin time(PT),activated partial thromboplastin time(APTT)and thrombin time(TT)of two groups of patients were increased when compared to before treatment,while fibrinogen(FIB)was decreased when compared to before treatment.The improvement was greater in combination group than monotherapy group(P<0.05).After 14 days of treatment,the levels of serum brain-derived neurotrophic factor(BDNF)and nerve growth factor(NGF)in both groups of patients were increased when compared to before treatment,while the levels of nerve growth associated protein-43(GAP-43)and myelin basic protein(MBP)were decreased when compared to before treatment.The improvement was more obvious in combination group(P<0.05).There is no statistically significant difference in the incidence of adverse reactions between

关 键 词：缺血性脑卒中 尼麦角林 神经节苷脂钠 凝血功能 神经递质 

分 类 号：R971[医药卫生—药品] R743.3[医药卫生—药学]