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目的:探讨急性脑出血(ACH)应用乌司他丁(UTI)联合醒脑静治疗的临床效果及对患者血清超敏C反应蛋白(hs-CRP)、D-二聚体(D-D)、神经元特异性烯醇化酶(NSE)水平的影响。方法:选取我院2015年1月~2016年12月收治的110例ACH患者,按照随机数字表法均分为两组。对照组仅予以UTI治疗,观察组予UTI联合醒脑静治疗。记录比较两组脑水肿吸收疗效,治疗前后NIHSS评分、血清hs-CRP、D-D及NSE水平,并评价两组用药安全性。结果:治疗14d后,观察组脑血肿吸收的总有效率为89.1%,显著高于对照组的67.3%(P<0.01)。两组治疗14 d后NIHSS评分均显著低于治疗前(P<0.01),观察组治疗14 d后NIHSS评分的改善效果较对照组更为显著(P<0.01)。与治疗前对比,两组治疗14 d后血清hs-CRP、D-D及NSE水平均显著降低(P<0.01),且观察组治疗14 d后血清学指标的改善效果均显著优于对照组同期(P<0.01)。观察组不良反应率为3.6%,与对照组的5.5%相比差异无统计学意义(P>0.05)。结论:乌司他丁联合醒脑静治疗更能迅速缓解或消除急性脑出血患者的血肿,控制机体炎性反应,改善凝血系统与纤溶系统状态,保护神经细胞,减轻神经功能损伤,效果显著且安全性高。
Objective: To investigate the clinical effect of UTI combined with Xingnaojing on acute cerebral hemorrhage (ACH) and its clinical significance on serum hs-CRP, D-dimer (DD), nerve Effect of methotrexate enolase (NSE) levels. Methods: A total of 110 ACH patients admitted from January 2015 to December 2016 in our hospital were randomly divided into two groups according to random number table. The control group was treated with UTI only, and the observation group was treated with UTI combined with Xingnaojing. Record the brain edema absorption efficacy, NIHSS score before and after treatment, serum hs-CRP, D-D and NSE levels, and evaluate the safety of the two groups. Results: After 14 days of treatment, the total effective rate of cerebral hematoma absorption in the observation group was 89.1%, which was significantly higher than that in the control group (67.3%, P <0.01). The NIHSS scores of the 14th day after treatment in both groups were significantly lower than those before treatment (P <0.01). The improvement effect of NIHSS in the observation group after 14 days of treatment was more significant than that of the control group (P <0.01). Compared with those before treatment, the levels of hs-CRP, DD and NSE were significantly decreased in both groups after 14 days of treatment (P <0.01), and the improvement effect of serum indexes in the observation group after 14 days of treatment was significantly better than that of the control group P <0.01). The adverse reaction rate in the observation group was 3.6%, which was not significantly different from 5.5% in the control group (P> 0.05). Conclusion: The combination of ulinastatin and xingnaojing can relieve or eliminate the hematoma in patients with acute cerebral hemorrhage, control the inflammatory reaction, improve the state of coagulation system and fibrinolytic system, protect the nerve cells and reduce the nerve function damage And high security.