目的 探讨尤瑞克林联合依达拉奉治疗对急性脑梗死患者脑血管储备功能及神经功能的影响.方法 选取我院脑科收治的68例急性脑梗死患者为研究对象,参照随机对照表分为对照组与观察组,每组34例,患者入院后均予以调脂、抗血小板聚集、神经保护等综合治疗,对照组在综合治疗基础上加用依达拉奉注射液,观察组予以尤瑞克林联合依达拉奉治疗,2组均治疗2周.疗程结束后,观察2组临床疗效,治疗前后采用经颅多普勒超声技术检测2组脑血管储备功能(CVR)及脑血流动力学指标,并采用美国国立卫生研究院卒中量表(NIHSS)及改良Barthel指数评定量表(MBI)评估联2组治疗前、治疗1周、治疗2周神经功能缺损症状,同时观察2组治疗期间出现的不良反应.结果 治疗后,对照组总有效率76%,明显低于观察组94%(P<0.05);2组峰流速(Vp)、平均流速(Vm)、CVR及抗氧化指标超氧化物歧化酶(SOD)、谷胱甘肽(GSH)、NO明显升高,脉动指数(PI)及炎性因子白细胞介素(IL)-6明显下降,且观察组各指标均明显优于对照组(P<0.05);2组神经细胞因子神经元特异性烯醇化酶(NSE)、NIHSS评分较治疗前显著下降,神经营养因子(NTF)、神经生长因子(NGF)及MBI评分较治疗前显著升高,且观察组各指标均优于对照组(P<0.05);对照组不良反应总发生率15%,与观察组12%差异无统计学意义(P>0.05).结论 尤瑞克林联合依达拉奉有有效改善急性脑梗死患者脑部血液循环,提高机体稳定脑血管灌注能力,继而提高CVR,保护缺血缺氧处神经功能,显著提高临床疗效,且未增加明显不良反应,安全性较好.%Objective To explore the effects of urinary kallidinogenase combined with edaravone on cerebral vascular reserve function and nerve function in patients with acute cerebral infarction .Methods Sixty-eight cases of patients with acute cerebral infarction admitted in the brain department of our hospital were selected for the study and divided into the control group and the observation group according to the random number table method , with 34 cases in each group .Patients were given the lipid-lowering ,anti-platelet aggregation ,neurological protec-tion and other comprehensive treatments after admitting to the hospital ,and the control group was additionally treated with edaravone injection on the basis of comprehensive treatments and the observation group was given uri-nary kallidinogenase combined with edaravone treatment ,and the two groups were treated for 2 weeks .After the course of treatment ,the clinical efficacy was observed between the two groups ,and the cerebral vascular reserve function (CVR) and cerebral hemodynamics were measured by transcranial Doppler ultrasonography before and af-ter treatment .The National Institutes of Health Stroke Scale (NIHSS ) and the modified Barthel index scale (MBI) were used to assess the neurological deficits in the two groups before and after 1 week of treatment and 2 weeks of treatment ,and the adverse reactions of the two groups were observed during the treatment. Results Af-ter treatment ,the total effective rate of the control group was 76% ,which was significantly lower than that in the observation group with 94% ( P <0 .05) .The levels of Vp ,Vm ,CVR and antioxidant indexes SOD ,GSH and NO were significantly increased while the levels of PI and inflammatory factor IL-6 were significantly decreased be-tween the both groups ,and the levels of the indexes in the observation group were significantly better than those of the control group ( P<0 .05) .The scores of nerve cell factors NSE and NIHSS in the two groups were signifi-cantly lower than those before treatment while the scores of NTF ,NGF and MBI were significantly higher than those before treatment ,and the scores of the indexes in the observation group were better than those in the control group ( P <0 .05) .The total incidence rate of adverse reactions in the control group was 15% ,which was not significantly different from that in the observation group with 12% ( P>0 .05) .Conclusion Urinary kallidinoge-nase combined with edaravone can have a significant improvement of brain blood circulation in patients with acute cerebral infarction ,and improve the body's ability to stabilize cerebrovascular perfusion to improve the cerebrovas-cular reserve function and protect the nerve function under hypoxia .What's more ,it can significantly improve clin-ical efficacy without increasing any obvious adverse reactions but with good safety .
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