舒血宁注射液对脑梗死患者临床疗效及血浆Hcy、UCH-L1及血清fibulin-5水平的影响

目的 探讨舒血宁注射液对脑梗死患者疗效及血浆同型半胱氨酸(Hcy)、泛素羧基末端水解酶-1(UCH-L1)及血清衰老关键蛋白抗原-5(fibulin-5)水平的影响.方法 选取124例脑梗死患者,根据随机数字表法将患者分为治疗组(n=62)及对照组(n=62),两组均接受神经内科常规治疗,同时给予依达拉奉辅助治疗,治疗组在对照组基础上给予舒血宁注射液静脉输注治疗,比较两组治疗效果、神经功能、日常生活恢复情况、血液流变学指标及治疗前后血浆Hcy、UCH-L1及血清fibulin-5水平变化.结果 治疗组总有效率为93.55％,对照组总有效率为77.42％,差异有统计学意义(P<0.05).治疗组治疗后美国国立卫生院神经功能缺损评分(NIHSS)为(5.18±0.86)分低于对照组(9.78±1.18)分(P<0.05),而日常生活功能评分(ADL)为(74.96±5.26)分高于对照组(61.42±4.85)分(P<0.05).治疗组治疗后血浆D-二聚体(D-D)、纤维蛋白原(FIB)、血浆黏度(CP)、红细胞聚集指数(RCAI)水平分别为(125.22±22.45)μg·L-1、(128.96±23.69)g·L-1、(1.52±0.47)mPa·s、(0.82±0.14)％,对照组治疗后D-D、FIB、CP、RCAI水平分别为(215.98±24.98)μg·L-1、(219.33±20.77)g·L-1、(1.78±0.38)mpa·s、(1.10±0.21)％,比较差异有统计学意义(P<0.05).治疗组治疗后血浆Hcy、UCH-L1及血清fibulin-5水平分别为(8.52±1.63)μmol·L-1、(0.25±0.12)μg·L-1、(45.22±2.96)μg·L-1,对照组治疗后血浆Hcy、UCH-L1及血清fibulin-5水平分别为(10.36±2.45)μmol·L-1、(0.40±0.18)μg·L-1、(68.96±4.85)μg·L-1,差异有统计学意义(P<0.05).结论 舒血宁注射液能有效提高脑梗死患者临床治疗效果,改善患者血液黏稠度,降低血浆Hcy、UCH-L1、fibulin-5水平,有利于脑梗死患者预后.

Effects of Shuxuening on the clinical efficacy of patients with cerebral infarction and the levels of plasma Hcy,UCH-L1,fibulin-5

Objective To investigate the effects of Shuxuening on the clinical efficacy of patients with cerebral infarction and the levels of plasma homocysteine (Hcy),ubiquitin carboxyl-terminal hydrolase-1 (UCH-L1),fibulin-5. Methods One hundred and twenty-four cases of patients with cerebral infarction were assigned into observation groups (n=62) and control group (n=62) from June 2014 to June 2016 in Department of Medical Examination,The Fourth Hospital of Qinhuangdao. Two groups were treated with conventional neu-rologic therapy and adjuvant therapy of edaravone. On this basis, observation group received intravenous infusion of Shuxuening. The therapeutic effects of two groups were compared. The nerve function,daily life recovery,hemorheology and the levels of Hcy,UCH-L1, fibulin-5 of two groups before and after treatment were compared. Results The total effective rate of control group was 77. 42％ and that of observation group was 93. 55％;there was statistically significant difference (P<0. 05). The levels of NIH neurological deficits (NIHSS) of observation group (5.18 ±0.86) after treatment were lower than the control group (9.78 ±1.18) (P<0.05),while the rates of daily living (ADL) (74. 96 ± 5. 26) were higher than control group (61. 42 ± 4. 85) (P<0. 05). The levels of plasma D-di-mer (D-D) (125.22 ±22.45) μg·L-1,fibrinogen (FIB) (128. 96 ± 23. 69) g·L-1,plasma viscosity (CP) (1. 52 ± 0. 47) mPa·s,erythrocyte aggregation index (RCAI) (0. 82 ± 0. 14)％ of observation group after treatment were lower than control group (P<0.05).ThelevelsofplasmaHcy(8.52±1.63) μmol·L-1,UCH-L1(0.25±0.12) μg·L-1,fibulin-5(45.22±2.96) μg·L-1 of observation group after treatment were lower than control group (10. 36 ± 2. 45) μmol·L-1,(0. 40 ± 0. 18) μg·L-1,(68. 96 ± 4.85) μg·L-1 (P <0. 05). Conclusions Shuxuening can improve clinical outcomes,blood viscosity and decrease plasma Hcy, UCH-L1,fibulin-5 levels in patients with cerebral infarction,which is beneficial to the prognosis of patients with cerebral infarction.