Objective To investigate the clinical effect of Vipocetine combined with Edaravone in the treatmentof acute cerebral infarction and the effect on the recovery of neurological function.Method 232 patients with acute cerebral infarction of our hospital were selected as the subjects from January 2013 to December 2016, according to the random number table, the patients were divided into control group and observation group all of which were treated with anti platelet aggregation, lipid lowering plaque,monitoring and controlling blood pressure, maintaining electrolyte balance and other conventional treatment. Patients in control group were injected with edaravone; observation group patients were treated with Vinpocetine on the basis of control group, after a course of treatment, cerebral perfusion index and serum index were compared between the two groups. National Institute of Health Stroke Scale (NIHSS), Glasgow coma score (GCS), and the total efficiency of the two groups were compared 2 months after discharge.Result The NIHSS scores in the two groups after treatment were significantly lower than that before treatment (P<0.05), the NIHSS scores in observation group were significantly lower than control group after treatment (P<0.05), the GCS in observation group was significantly higher than control group after treatment (P<0.05). The CBF and CBV of observation group were significantly improved than that of control group (P<0.05). The MTT, GAP-43, MMP-2, MMP-9, TM, PF4 of observation group were significantly reduced than that of control group (P<0.05). The total effective rate of observation group was significantly higher than that of control group (P<0.05).Conclusion Edaravone combined with Vinpocetine in the treatment of acute cerebral infarction can improve the NIHSS score and GCS, increase the levels of CBF and CBV, reduce the MTT and the levels of GAP-43, MMP-2, MMP-9, TM, PF4 and blood index, the clinical efficacy is worthy of recognition.%目的 探讨长春西汀联合依达拉奉治疗急性脑梗死的临床效果及对患者神经功能恢复的影响.方法 选取2013年1月至2016年12月于本院就诊的急性脑梗死患者232例为研究对象.根据随机数表法将入选患者分为对照组(102例)和观察组(130例),所有患者均行抗血小板聚集、降脂固斑、控制血压、维持水电解质平衡等常规治疗.对照组患者注射依达拉奉,观察组患者在对照组治疗基础上加用长春西汀治疗.治疗1个疗程后比较两组患者脑血流灌注评价指标和血清学指标,出院2个月后随访比较两组患者美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分、格拉斯哥昏迷评分(Glasgow coma score,GCS)及临床疗效.结果 治疗后,两组患者NIHSS评分较治疗前均显著降低(P<0.05),GCS较治疗前均显著升高(P<0.05);观察组患者NIHSS评分显著低于对照组(P<0.05),GCS显著高于对照组(P<0.05).治疗后观察组患者脑血流量(cerebral bloodflow,CBF)和脑血容量(cerebral blood volume,CBV)较对照组均显著增加(P<0.001),脑血流平均通过时间(mean transit time,MTT)较对照组显著缩短(P<0.001),神经生长相关蛋白43(growth-associated protein 43,GAP-43)、基质金属蛋白酶(matrix metalloproteinases,MMP)-2、MMP-9、血栓调节蛋白(thrombomodulin,TM)及血小板因子4(platelet factor 4,PF4)含量均显著低于对照组(P<0.05,P<0.001).观察组患者治疗总有效率显著高于对照组(P<0.05).结论 长春西汀联合依达拉奉治疗急性脑梗死,能够明显改善患者NIHSS评分和GCS,显著增加CBF和CBV,有效缩短脑血流MTT,降低GAP-43、MMP-2、MMP-9、TM、PF4含量,临床治疗效果显著.
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