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目的研究增用奥拉西坦对高血压脑出血患者血浆降钙素原(PCT)、基质金属蛋白酶组织抑制剂-1(TIMP-1)以及基质金属蛋白酶-9(MMP-9)水平的影响,以期为临床治疗提供参考。方法选取2015年8月至2016年9月延安大学附属医院收治的高血压脑出血患者84例。根据随机数字表法分为观察组与对照组各42例。对照组患者予以常规治疗(包括降颅内压、脑蛋白水解物的应用以及并发症预防等),观察组则在对照组的基础上加用奥拉西坦治疗。两组均治疗21 d。疗程结束后比较两组疗效,治疗前后血浆PCT、TIMP-1及MMP-9水平,采用美国国立卫生研究院卒中量表(NIHSS)评分评价神经功能,采用Barthel指数评定量表(BI)评价日常生活活动能力。结果治疗21 d后观察组总有效率为92.86%,高于对照组的73.81%(P<0.05)。治疗后两组患者血浆PCT、TIMP-1及MMP-9水平低于治疗前,且观察组低于对照组(P均<0.01)。治疗后两组NIHSS评分均低于治疗前,而观察组低于对照组(P均<0.01)。治疗后两组BI评分均低于治疗前,而观察组低于对照组(P均<0.01)。结论增用奥拉西坦治疗高血压脑出血的临床疗效显著,可有效调节患者血浆PCT、TIMP-1及MMP-9水平,同时改善其神经功能,提高日常生活活动能力。
Objective To investigate the effects of oxiracetam on plasma levels of procalcitonin (PCT), tissue inhibitor of metalloproteinase-1 (TIMP-1) and matrix metalloproteinase-9 (MMP-9) in patients with hypertensive intracerebral hemorrhage , With a view to provide a reference for clinical treatment. Methods Eighty-four patients with hypertensive intracerebral hemorrhage admitted from the Yan’an University Affiliated Hospital from August 2015 to September 2016 were selected. According to random number table divided into observation group and control group, 42 cases each. Patients in the control group were treated routinely (including intracranial pressure reduction, application of brain protein hydrolysates and prevention of complications). The observation group was treated with oxiracetam on the basis of the control group. Both groups were treated for 21 days. The levels of PCT, TIMP-1 and MMP-9 in the two groups were compared after treatment. The NIHSS score was used to evaluate the neurological function. The Barthel Index Rating Scale (BI) was used to evaluate the daily Living activities ability. Results After 21 days of treatment, the total effective rate of the observation group was 92.86%, which was higher than that of the control group (73.81%, P <0.05). After treatment, the levels of plasma PCT, TIMP-1 and MMP-9 in the two groups were lower than those before treatment, and the observation group was lower than the control group (all P <0.01). After treatment, the NIHSS scores in both groups were lower than those before treatment, while those in the observation group were lower than those in the control group (all P <0.01). After treatment, the BI scores in both groups were lower than those before treatment, while those in the observation group were lower than those in the control group (all P <0.01). Conclusions The clinical efficacy of oxiracetam in the treatment of hypertensive intracerebral hemorrhage is significant, which can effectively regulate the levels of plasma PCT, TIMP-1 and MMP-9 in plasma, improve the neurological function and improve the activities of daily living.