醒脑静联合脑蛋白水解物治疗脑卒中的疗效及其对患者血管内皮依赖性舒张功能的影响

目的 探讨醒脑静注射液联合脑蛋白水解物治疗脑卒中的疗效及其对患者血管内皮依赖性舒张功能(FMD)变化率的影响.方法 选取2014年1月至2015年12月在我院住院治疗的脑卒中患者126例,采用随机数字表法随机分为观察组和对照组,每组63例.对照组在常规治疗的基础上加用脑蛋白水解物60 mL静脉滴注,观察组则在此基础上再联用醒脑静注射液20 mL,14 d为一个疗程,连续治疗2个疗程.比较两组患者的神经功能缺损评分、FMD变化、血流动力学、不良反应及心脑血管事件复发情况.结果 观察组患者在治疗14 d、1个月及6个月末的脑卒中临床神经功能缺损程度评分量表(CSS)评分分别为(9.57±2.46)分、(8.84±2.54)分、(7.25±2.35)分,均低于对照组患者的(16.22±2.92)分、(15.35±3.24)分、(13.76±2.97)分,差异均有统计学意义(P<0.05);观察组患者在治疗3 d、7 d和14 d末的FMD分别为(5.83±0.84)%、(6.47±0.62)%、(8.26±0.54)%,均高于对照组患者的(5.45±0.76)%、(5.62±0.79)%、(5.82±0.56)%,差异均有统计学意义(P<0.05);观察组患者在治疗14 d末的血浆黏度(1.09±0.34)mPa·s、全血黏度高切(2.71±0.85)mPa·s、全血黏度低切(5.62±0.63)mPa·s和纤维蛋白含量(2.26±0.66)g/L均低于对照组[分别为(1.57±0.39)mPa·s、(3.58±0.97)mPa·s、(6.52±0.83)mPa·s、(3.35±0.71)g/L],差异均有统计学意义(P<0.05);治疗14 d末,观察组患者的治疗有效率为93.65%,显效率为66.67%,均明显高于对照组的80.95%和44.44%,差异均有统计学意义(P<0.05);观察组患者的不良反应发生率为9.52%,与对照组的11.10%比较差异无统计学意义(P>0.05).结论 醒脑静联合脑蛋白水解物治疗脑卒中患者可明显改善神经功能缺损和脑血管内皮功能,安全性较好,有推广应用价值.

Clinical efficacy of Xingnaojing injection combined with cerebroprotein hydrolysate injection in treating patients with stroke and their influence on endothelium-dependent flow-mediated dilatation

Objective To analyze the clinical efficacy of Xingnaojing injection combined with cerebroprotein hydrolysate injection in treating patients with stroke and their influence on the change of flow-mediated dilatation (FMD). Methods A total of 126 patients with stroke in this hospital from Jan. 2014 to Dec. 2015 were chosen, and were randomly divided into observation group (63 cases) and control group (63 cases) by random number table. The pa-tients in control group were given conventional treatment plus 60 mL cerebroprotein hydrolysate intravenous dripping. The patients in observation group were treated additionally with 20 mL Xingnaojing injection intravenous dripping on the basis of therapy of controls. One course of treatment lasted 14 days and all patients accepted 2 courses of treatment. The scores of nervous functional defect, FMD level, haemodynamics, adverse reactions, and recurrence of adverse cardi-ocerebral vascular events between the two groups were compared. Results The CSS scores in patients of observation group after 14 days, 1 month and 6 months of treatment were (9.57±2.46), (8.84±2.54), (7.25±2.35), respectively, as com-pared with (16.22±2.92), (15.35±3.24), (13.76±2.97) in the control group (P<0.05). The level of FMD in patients of ob-servation group after 3, 7 and 14 days of treatment were (5.83 ± 0.84)%, (6.47 ± 0.62)%, (8.26 ± 0.54)%, respectively, as compared with (5.45±0.76)%, (5.62±0.79)%, (5.82±0.56)%in the control group (P<0.05). Plasma viscosity, whole blood viscosity high shear, whole blood viscosity low shear and FIB after 14 days of treatment in patients of observation group were (1.09±0.34) mPa·s, (2.71±0.85) mPa·s, (5.62±0.63) mPa·s, (2.26±0.66) g/L, respectively, all significantly lower than (1.57±0.39) mPa·s, (3.58±0.97) mPa·s, (6.52±0.83) mPa·s, (3.35±0.71) g/L of the controls (P<0.05). The effective rate of observation group was 93.65%, significantly higher than 80.95%of the controls (P<0.05), and the improving rate of observation group was 66.67%, also significantly higher than 44.44%of the controls (P<0.05). The incidence of ad-verse reactions in observation group was 9.52%, which showed no statistically significant difference with that of the con-trols (11.10%). Conclusion There is good efficacy in improving nervous functional defect and cerebrovascular endo-thelial function for Xingnaojing injection combined with cerebroprotein hydrolysate injection to treat patients with stroke together with safety, and it deserves to be promoted.