目的 观察尤瑞克林与丁苯酞对急性脑梗死(ACI)患者认知功能、血清细胞因子的影响.方法 选取2014年1月-2015年12月新疆生产建设兵团第十三师红星医院收治的ACI(依据头颅CT及MR诊断)患者136例作为研究对象,按入院顺序随机分为2组,观察组70例患者在常规基础治疗上使用尤瑞克林联合丁苯酞,对照组66例患者仅采用常规基础治疗,2组患者均连续治疗4周.采用神经功能缺损(NIHSS)量表评价患者中枢神经系统功能,简易精神状态量表(MMSE)评价患者认知功能,应用生物酶联免疫吸附试验检测患者血清细胞因子相关指标.对比2组患者治疗前、治疗2周和4周的NIHSS评分、MMSE评价和血清细胞因子相关指标的变化.结果 治疗前,2组患者的NIHSS、MMSE评分差异无统计学意义( t =1.191、1.145, P >0.05),治疗2、4周后均改善( P <0.01).治疗2周、4周,观察组患者的NIHSS评分均低于对照组( t =4.017、5.676, P =0.000、0.000);治疗4周,观察组患者的MMSE评分高于对照组( t =2.515, P =0.013).治疗前,2组患者的血清sCD40L、IL-18、hs-CRP、NO、eNOS、VEGF的水平差异无统计学意义( P >0.05),治疗后2周,2组上述指标均改善( P <0.01).治疗2周、4周,观察组血清sCD40L、IL-18、hs-CRP水平低于对照组( P <0.01),NO、eNOS、VEGF水平高于对照组( P <0.01).结论 尤瑞克林与丁苯酞治疗ACI患者能促进患者认知功能、神经功能恢复,减轻炎性反应.%Objective To investigate the effects of urinary kallidinogenase and butyphthalide on cognitive function and serum inflammatory cytokines in patients with acute cerebral infarction (ACI).Methods One hundred and thirty-six ACI patients (based on cranial CT and MRI diagnosis) admitted to hospital (from January 2014 to December 2015) were retrospectively analyzed, 70 patients were treated with conventional treatment based on the use of urinary kallidinogenase combined with butyphthalide (study group), 66 patients were only received conventional treatment (control group), the patients of two groups were treated for 4 weeks.The neurologic impairment scale (NIHSS) was used to evaluate the central nervous system function, cognitive function of patients was evaluated by Mini Mental State Scale (MMSE) score, and biological enzyme linked immunosorbent assay (ELISA) was used to detect serum factors related index.The NIHSS score, MMSE score and serum factors related index of two groups patients were compared before treatment, treatment for 2 weeks and 4 weeks.Results Before treatment, there was no significant difference in NIHSS and MMSE score between the two groups( t =1.191,1.145, P >0.05).After treatment for 2 weeks and 4 weeks, the NIHSS scores of the study group were lower than those of the control group( t =4.017, t =5.676, P =0.000, P =0.000);After treatment for 4 weeks, the MMSE scores of the study group were higher than those of the control group( t =2.515, P =0.013);Before treatment, the serum levels of sCD40L, IL-18, hs-CRP, NO, eNOS and VEGF of the two groups were not statistically significant( t =1.398, t =0.885, t =0.429, t =0.395, t =0.619, t =0.822, P =0.165, P =0.384, P =0.573, P =0.628, P =0.498, P =0.408).After treatment for 2 weeks and 4 weeks, the serum levels of sCD40L, IL-18 and hs-CRP of the study group were lower than those of the control group( t =6.055, t =6.898, t =5.574, t =4.023, t =4.104, t =6.751, P =0.000, P =0.000, P =0.000, P=0.000, P =0.000, P =0.000),and the levels of NO, eNOS and VEGF of the study group were higher than those of the control group( t =2.814, t =3.904, t =3.028, t =5.574, t =3.518, t =2.708, P =0.010, P =0.000, P =0.002, P=0.000, P =0.000, P =0.012).Conclusion The urinary kallidinogenase and butyphthalide in the treatment of patients with ACI can promote cognitive function, neurological function recovery, reduce inflammatory response.
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