氢溴酸樟柳碱对大面积脑梗死血管储备功能及预后的影响研究  

Effect of anisodine hydrobromide on vascular reserve function and prognosis in large area cerebral infarction

作　　者：任梦媛 赵媛媛 REN Mengyuan;ZHAO Yuanyuan(Pharmacy Department,Yellow River Conservancy Commission Yellow River Central Hospital,Zhengzhou,Henan 450000,China)

机构地区：[1]黄河水利委员会黄河中心医院药剂科,河南郑州450000

出　　处：《中国医学工程》2025年第4期101-105,共5页China Medical Engineering

摘　　要：目的观察氢溴酸樟柳碱对大面积脑梗死患者脑血管储备功能及预后情况的影响。方法该研究为前瞻性研究,研究对象为黄河水利委员会黄河中心医院2022年1月至2023年6月期间收治的118例大面积脑梗死患者,应用计算机随机数字表法生成随机序列,并进行分配隐藏后,将入组患者分为常规组和试验组,各59例。常规组予以常规药物治疗,试验组采用氢溴酸樟柳碱辅助常规药物治疗,治疗结束后随访1年,比较两组患者的脑血流动力学[脑血容量(CBV)、脑血流量(CBF)、中央动脉平均血流速度(Vm)、动脉峰值流速(Vp)]、脑血液流变学[血浆黏度、高切黏度、低切黏度、低灌注指数(HIR)]、氧化应激指标[超氧化物歧化酶(SOD)、还原型谷胱甘肽(GSH)、乳酸脱氢酶(LDH)、一氧化氮(NO)]反应及预后情况(语言障碍、吞咽障碍、意识障碍、偏瘫)。结果在不同治疗方案下,试验组的CBV、CBF、Vm、Vp分别为(3.55±0.31)mL/100 g、(45.29±10.36)mL/100 g、(55.45±10.27)cm/s、(70.42±10.33)m/s,均高于常规组[(2.95±0.33)mL/100 g、(40.33±10.26)mL/100 g、(50.25±10.33)cm/s、(65.34±10.26)m/s](P<0.05);试验组的血浆黏度、高切黏度、低切黏度、HIR分别为(1.25±0.31)mPa·s、(8.33±1.36)mPa·s、(5.45±1.33)mPa·s、(0.37±0.12),均低于常规组[(2.19±0.75)mPa·s、(10.42±2.33)mPa·s、(6.37±1.84)mPa·s、(0.72±0.21)](P<0.05);试验组的SOD、GSH分别为(85.36±10.25)U/mL、(45.25±10.33)U/L,均高于常规组[(80.34±10.41)U/mL、(40.66±10.41)U/L],LDH、NO分别为(202.36±20.45)U/L、(32.25±5.16)μmol/L,均低于常规组[(217.45±20.34)U/L、(35.63±5.22)μmol/L](P<0.05);试验组的不良预后发生率[3.39%(2/59)]低于常规组[18.64%(11/59)](P<0.05)。结论氢溴酸樟柳碱辅助治疗大面积脑梗死能改善患者脑血流动力学及脑血液流变学,对改善患者脑血管储备功能、提高脑组织抗氧化力并改善患者预后情况均有积极意义。【Objective】To observe the effect of anisodine hydrobromide on cerebral vascular reserve function and prognosis in patients with extensive cerebral infarction.【Methods】This study is a prospective study,with 118 patients with extensive cerebral infarction admitted to Yellow River Conservancy Commission Yellow River Central Hospital from January 2022 to June 2023.The computer randomization method was used to generate random sequences,and after allocation concealment,the enrolled patients were divided into a conventional group(59 cases)and an experimental group(59 cases).The conventional group received conventional drug treatment,while the experimental group received anisodine hydrobromide as an adjuvant conventional drug treatment.After one year of follow-up after treatment,the cerebral hemodynamics[cerebral blood volume(CBV),cerebral blood flow(CBF),central artery mean blood flow velocity(Vm),arterial peak flow velocity(Vp)],and cerebral hemorheology[plasma viscosity,high shear viscosity,low shear viscosity,low perfusion index(HIR)],oxidative stress indicators[superoxide dismutase(SOD),reduced glutathione(GSH),lactate dehydrogenase(LDH),nitric oxide(NO)]reactions and prognosis(language disorders,swallowing disorders,consciousness disorders,hemiplegia)of the two groups of patients were compared.【Results】Under different treatment regimens,the CBV,CBF,Vm,and Vp of the experimental group were 3.55±0.31 mL/100g,45.29±10.36 mL/100g,55.45±10.27 cm/s,and 70.42±10.33 m/s,respectively,which were higher than those of the conventional group(2.95±0.33 mL/100g,40.33±10.26 mL/100g,50.25±10.33 cm/s,65.34±10.26 m/s),and the difference was statistically significant(t=10.179,2.613,2.742,2.680;P<0.05).The plasma viscosity,high shear viscosity,low shear viscosity,and HIR of the experimental group(1.25±0.31 mPa·s,8.33±1.36 mPa·s,5.45±1.33 mPa·s,and 0.37±0.12)were all lower than those in the conventional group(2.19±0.75 mPa·s,10.42±2.33 mPa·s,6.37±1.84 mPa·s,and 0.72±0.21),and the difference was statisti

关 键 词：大面积脑梗死 氢溴酸樟柳碱 脑血管储备功能 抗氧化力 预后情况 

分 类 号：R743.33[医药卫生—神经病学与精神病学]