乙酰谷酰胺联合长春西汀治疗急性脑梗死的疗效观察

目的探讨乙酰谷酰胺与长春西汀联合治疗急性脑梗死患者的安全性与有效性。方法选取于2016年6月—2017年6月在泸州市人民医院治疗的急性脑梗死患者134例,随机分成对照组和治疗组,每组各67例。对照组患者静脉滴注长春西汀注射液,20 mg加入500 m L生理盐水,1次/d;治疗组患者在对照组基础上静脉滴注注射用乙酰谷酰胺,300 mg加入10%葡萄糖溶液250 mL,1次/d。两组患者治疗14 d。观察两组患者临床疗效,同时比较治疗前后两组患者血清血管内皮生长因子(VEGF)、神经元特异性烯醇化酶(NSE)和局部脑血流量(rCBF)水平,NIHSS、ESS和ADL评分及不良反应情况。结果治疗后,对照组和治疗组临床有效率分别为82.09%和95.52%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者血清VEGF和rCBF水平均显著升高(P0.05),NSE水平显著降低(P0.05),且治疗组患者VEGF、NSE和rCBF水平明显好于对照组(P0.05)。治疗后,两组患者NIHSS评分显著降低(P0.05),ADL和ESS评分显著升高(P0.05),且治疗组患者NIHSS、ESS和ADL评分明显好于对照组(P0.05)。治疗期间,治疗组患者的不良反应发生率为2.99%,显著低于对照组患者的14.93%,两组比较差异具有统计学意义(P0.05)。结论乙酰谷酰胺联合长春西汀治疗急性脑梗死安全性高,临床疗效好,具有一定的临床推广应用价值。

Clinical observation of acetylglutamate combined with vinpocetine in treatment of acute cerebral infarction

Objective To investigate the safety and efficacy of acetylglutamate combined with vinpocetine in treatment of acute cerebral infarction. Methods Patients (134 cases) with acute cerebral infarction in Luzhou People''s Hospital from June 2016 to June 2017 were randomly divided into control (67 cases) and treatment (67 cases) groups. Patients in the control group were iv administered with Vinpocetine Injection, 20 mg added into normal saline 500 mL, once daily. Patients in the treatment group were iv administered with Aceglutamide for injection on the basis of the control group, 300 mg added into 10% glucose solution 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the VEGF, NSE, rCBF levels, NIHSS, ESS and ADL scores, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 82.09% and 95.52%, respectively, and there were differences between two groups (P<0.05). After treatment, the serum VEGF and rCBF levels in two groups were significantly increased (P<0.05), but NSE levels were significantly decreased (P<0.05), and these indexes in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the NIHSS scores in two groups were significantly decreased (P<0.05), ADL and ESS scores were significantly increased (P<0.05), and these scores in the treatment group were significantly better than those in the control group (P<0.05). During the treatment, the adverse reactions rate in the treatment group was 2.99%, which was significantly lower than 14.93% in the control group, with significant difference between two groups (P<0.05). Conclusion Acetylglutamate combined with vinpocetine has high safety and significant clinical efficacy in treatment of acute cerebral infarction, which has a certain clinical application value.