阿加曲班联合神经节苷脂对急性脑梗死患者的疗效观察

摘要/Abstract

摘要： 目的研究阿加曲班联合神经节苷脂对急性脑梗死患者的疗效。方法选择2020年1月—2021年12月西安市华山中心医院收治的80例急性脑梗死患者,根据治疗方法分为对照组和观察组,每组40例。对照组患者采用阿加曲班治疗,观察组患者采用阿加曲班联合神经节苷脂治疗。两组均治疗7 d。检测对比两组疗效,治疗前后血清白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、超敏C反应蛋白（hs-CRP）及脑血流动力学指标（全血低切黏度、大脑中动脉血流速度、全血高切黏度、大脑前动脉血流速度、血细胞比容以及大脑后动脉血流速度）。结果观察组治疗有效率高于对照组（P<0.05）;治疗后,两组的血清IL-6、IL-8和hs-CRP水平均明显降低（P<0.05）,且观察组的血清IL-6、IL-8和hs-CRP水平明显低于对照组（P<0.05）;治疗后,两组的血细胞比容、全血高切黏度、全血低切黏度均降低,大脑前动脉血流速度、大脑中动脉血流速度、大脑后动脉血流速度均升高（P<0.05）,且观察组的血细胞比容、全血高切黏度、全血低切黏度均低于对照组,大脑前动脉血流速度、大脑中动脉血流速度、大脑后动脉血流速度均高于对照组（P<0.05）。结论阿加曲班联合神经节苷脂治疗急性脑梗死患者,可有效减轻炎症反应,改善患者的脑血流动力学,从而提高疗效,值得应用。

关键词: 阿加曲班, 神经节苷脂, 急性脑梗死

Abstract: Objective To investigate the effect Agatroban combined with Ganglioside in patients with acute stroke. Methods 80 patients with acute cerebral infarction admitted to Xian Huashan Central Hospital from January 2020 to December 2021 were selected and divided into two groups according to the treatment method. The control group of patients with acute cerebral infarction used Agatroban, and the observation group of patients with acute cerebral infarction used Agatroban combined with Ganglioside. The two groups were treated for 7 d. The curative effect, before and after the treatment of serum interleukin-6 (IL-6), interlenkin-8 (IL-8), hypersensitive Creactive protein (hs-CRP) and cerebral hemodynamic indicators (whole blood low shear viscosity, middle cerebral artery blood flow velocity, whole blood high shear viscosity, anterior cerebral artery blood flow velocity, blood cell volume and posterior cerebral artery blood flow velocity) of two groups were compared. Results The observation group was more effective than the control group (P<0.05). After treatment, the serum levels of IL-6, IL-8 and hs-CRP in the two groups were significantly decreased (P<0.05), the serum levels of IL-6, IL-8 and hs-CRP in the observation group were significantly lower than those in the control group (P<0.05). After treatment, the hematocrit, whole blood high-cut viscosity and whole blood low-cut viscosity of the two groups were all decreased, before the cerebral artery blood flow velocity, middle cerebral artery blood flow velocity, posterior cerebral artery blood flow velocity were increased (P<0.05), and the observation group of hematocrit, whole blood high shear viscosity, whole blood low shear viscosity are lower than the control group, before the cerebral artery blood flow velocity, middle cerebral artery blood flow velocity, posterior cerebral artery blood flow velocity were higher than control group (P<0.05). Conclusion Agatroban combined with Ganglioside can effectively reduce the inflammatory response, improve the cerebral hemodynamics in patients, and thus improve the efficacy, which is worth application.

Key words: agaquban, gangliosides, acute stroke

中图分类号:

R741

王托弟, 李彦军, 慕翔宇, 黄旌. 阿加曲班联合神经节苷脂对急性脑梗死患者的疗效观察[J]. 中华养生保健, 2023, 41(6): 4-5.

WANG Tuo-di, LI Yan-jun, MU Xiang-yu, HUANG Jing. Observation on the Therapeutic Effect of Agatroban Combined with Ganglioside in Patients with Acute Stroke[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(6): 4-5.

参考文献 19

[1]	邹明宏,保潞娟,刘成.低分子肝素与胞二磷胆碱联合治疗急性脑卒中的临床疗效及其血清炎性因子的变化[J].临床和实验医学杂志,2021,20(9):920-923.
[2]	林海鸟,朱聪,苏红侠,等.应急预案急救流程配合绿色通道在急性脑卒中患者中的应用研究[J].中国中西医结合急救杂志,2021,28(6): 723-726.
[3]	秦锐,谢宏斌,苏茜.神经节苷脂联合临床康复路径对急性脑梗死患者临床疗效,认知功能及神经功能的影响[J].疑难病杂志,2020, 19(9):892-895.
[4]	中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中国全科医学,2011,14(35):4013-4017.
[5]	刘金平,李柱.中药活血通络方联合静脉溶栓对急性脑卒中病人脑血流灌注及血管内皮功能的影响[J].中西医结合心脑血管病杂志,2020,18(4):678-681.
[6]	董玉茹,王胜,于瑾,等.基于高分辨核磁血管成像技术的急性卒中患者颅内外动脉狭窄部位的人群特征分析[J].中国CT和MRI杂志,2020,18(9):28-30,59.
[7]	吕日琅,汪明佳,姜超,等.经动脉导管局部替罗非班给药对超时间窗急性脑卒中患者脑血流动力学及神经功能损伤的影响[J].海南医学,2022,33(7):825-828.
[8]	王霞,彭明洋,王鹏,等.基于DWI和灌注加权成像的机器学习预测急性脑卒中机械取栓后早期神经功能恶化[J].临床神经病学杂志,2021,34(5):321-325.
[9]	鲍月红,潘君君.配偶参与式注意力训练与言语听觉反馈训练用于急性脑卒中病人认知功能康复的临床研究[J].蚌埠医学院学报,2020, 45(8):1118-1122.
[10]	张福琴,钟华,朱利莉,等.急性脑卒中患者发生认知功能障碍的危险因素分析及风险列线图模型的建立[J].中风与神经疾病杂志,2020,37(10):886-890.
[11]	任会菊,郑东焕,高园园,等.银杏酮酯滴丸联合阿加曲班注射液治疗急性脑梗死的临床研究[J].现代药物与临床,2020,35(4):701-705.
[12]	王若兰,韩祖成,袁捷,等阿加曲班联合阿替普酶静脉溶栓治疗急性缺血性脑卒中有效性及安全性的meta分析[J].中国医药导报,2022, 19(20):70-74.
[13]	黄文立,宫淑杰,洪全龙.阿加曲班注射液治疗静脉溶栓后24 h内进展性卒中患者的临床研究[J].中国临床药理学杂志,2020,36(19): 2965-2967,2975.
[14]	蒋燕,蒋育欣,蒋卓晔.阿托伐他汀联合神经节苷脂对脑梗死康复期患者临床疗效及MBP,GAP-43,TGF-β1的影响[J].临床和实验医学杂志,2021,20(6):602-606.
[15]	刘莉,陈光耀,张玉,等.神经节苷脂联合胞磷胆碱及亚低温疗法对新生儿缺氧缺血性脑病血清VEGF,sICAM-1水平及预后的影响[J].医学综述,2020,26(4):823-828.
[16]	王洪涛,徐韦琳,陈晓晴.神经节苷脂钠注射液治疗脑梗死后血管性痴呆的疗效及对炎症因子的影响[J].心脑血管病防治,2021,21(6): 588-591.
[17]	夏雪龙. 神经节苷脂治疗急性脑卒中患者的疗效及对血清中TNF-α和IL-6水平的影响[J].医学综述,2014,20(22):4214-4215.
[18]	梁群娣,吴文军,梁韵.血清甲状腺素和免疫炎症因子与青年急性缺血性脑卒中患者卒中严重程度的相关性[J].中国急救复苏与灾害医学杂志,2020,15(5):547-549,565.
[19]	胡明洁,张凤英,刘慧影.超敏cTnT与血栓-炎症因子的相关性及其对急性缺血性脑卒中神经功能结局的预测价值[J].新医学,2021, 52(3):203-207.