论文部分内容阅读
目的探讨尤瑞克林治疗急性分水岭脑梗死(cerebral watershed infarction,CWI)的效果及其对患者血清S-100B蛋白、神经元特异性烯醇化酶(neuron specific enolase,NSE)水平的影响。方法 120例急性CWI患者随机分为观察组和对照组各60例,对照组给予抗血小板等常规治疗,观察组在对照组治疗基础上给予尤瑞克林0.15PNAU+生理盐水100mL,静脉滴注,1次/d,连续应用14d。分别于治疗前及治疗7、14d后检测2组血清S-100B蛋白、NSE水平,应用美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分评估2组神经功能缺损情况,治疗后14d评定临床疗效,治疗后30、90d行Barthel指数评分评定患者日常生活活动能力,并进行比较。结果观察组治疗7、14d后S-100B蛋白[(2.6±1.3)、(2.3±1.2)μg/L]、NSE[(5.6±3.1)、(4.8±2.3)μg/L]均低于治疗前[(6.3±2.6)、(16.9±6.5)μg/L](P<0.05);对照组治疗14d后S-100B蛋白[(3.0±1.6)μg/L]、NSE[(6.3±2.9)μg/L]低于治疗前[(7.0±3.0)、(17.6±6.8)μg/L](P<0.05);2组治疗14d后S-100B蛋白、NSE水平比较差异无统计学意义(P>0.05);观察组、对照组治疗14d后NIHSS评分[(3.6±1.7)、(6.6±2.5)分]均较治疗前[(11.9±4.0)、(10.3±4.8)分]降低(P<0.05),且观察组低于对照组(P<0.05);治疗14d后观察组有效率(91.7%)高于对照组(66.7%)(P<0.05);观察组治疗30、90d后Barthel指数评分[(79.2±11.2)、(89.4±12.9)分]高于治疗前[(53.2±10.6)分](P<0.05);对照组治疗90d后Barthel指数评分[(78.0±12.2)分]高于治疗前[(54.6±12.2)分](P<0.05);观察组治疗30、90d后Barthel指数评分高于对照组(P<0.05)。结论急性CWI患者在常规治疗基础上应用尤瑞克林治疗可降低血清S-100B蛋白、NSE水平,改善患者神经功能缺损,提高疗效。
Objective To investigate the effect of uracil on acute cerebral watershed infarction (CWI) and its effect on serum S-100B protein and neuron specific enolase (NSE) levels. Methods A total of 120 patients with acute CWI were randomly divided into observation group (60 cases) and control group (60 cases). The control group was treated with conventional therapy such as antiplatelet. The observation group received 100 mL of irinocuin 0.15PNAU + saline, intravenous drip, 1 time / d, continuous application 14d. The levels of serum S-100B protein and NSE were measured before treatment and 7 and 14 days after treatment respectively. The neurological deficits were evaluated in the two groups according to the National Institutes of Health Stroke Scale (NIHSS) Clinical efficacy was assessed 14 days after treatment. The Barthel index score was used to assess the daily activities of patients at 30 and 90 days after treatment, and compared. Results The levels of S-100B protein [(2.6 ± 1.3) and (2.3 ± 1.2) μg / L] and NSE [(5.6 ± 3.1) and (4.8 ± 2.3) μg / L] (P <0.05); S-100B protein [(3.0 ± 1.6) μg / L], NSE [(6.3 ± 2.9) (P <0.05). There was no significant difference in the levels of S-100B protein and NSE between the two groups after 14 days of treatment (P <0.05) > 0.05). NIHSS scores in the observation group and the control group after 14 days of treatment were significantly lower than those before treatment [(11.9 ± 4.0), (10.3 ± 4.8) points, respectively, (3.6 ± 1.7) vs (6.6 ± 2.5) 0.05), and the observation group was lower than the control group (P <0.05). After 14 days of treatment, the observation group’s effective rate (91.7%) was higher than that of the control group (66.7%) The scores of Barthel index [(79.2 ± 11.2), (89.4 ± 12.9) points] were significantly higher than those before treatment (53.2 ± 10.6) (P <0.05) (54.6 ± 12.2) points before treatment (P <0.05). The Barthel index score of the observation group after 30 and 90 days of treatment was higher than that of the control group (P <0.05). Conclusion The application of ureclin in the treatment of acute CWI can reduce the level of serum S-100B protein and NSE, improve the neurological deficits and improve the curative effect.