吡拉西坦联合胞磷胆碱对急性脑梗死认知功能和神经功能的影响

目的:研究吡拉西坦联合胞磷胆碱对急性脑梗死认知功能和神经功能的影响。方法:选择2014年1月～2018年1月我院的150例急性脑梗死患者,随机分为两组。对照组采用吡拉西坦治疗,观察组采用吡拉西坦联合胞磷胆碱治疗。采用神经功能缺损程度(National Institutes of Health Stroke Scale,NIHSS)、析蒙特利尔认知评估量表(Montreal cognitive assessment scale,Mo CA)和日常生活能力(Activities of daily living,ADL)评分量表,比较两组治疗前后神经功能、认识功能和日常生活能力变化。结果:观察组基本治愈15例,显效30例,有效26例,无效4例,恶化1例,总有效率为94.67%,明显高于对照组(P0.05);治疗后,两组的ADL和Mo CA评分明显升高,神经功能缺损量表(National Institutes of Health Stroke Scale,NHISS)评分明显降低,且观察组的ADL、Mo CA和NHISS评分明显优于对照组(均P0.05);治疗后,两组的血清细胞凋亡蛋白酶-3(cysteinyl aspartate specific proteinase-3,Caspase-3)和低氧诱导因子-1α(Hypoxia-inducible factor 1α,HIF-1α)水平均明显降低,且观察组明显低于对照组(均P0.05);对照组发生干呕1例(1.33%),恶心2例(2.67%),头痛1例(1.33%),头晕1例(1.33%);观察组发生干呕1例(1.33%),恶心1例(1.33%),头痛1例(1.33%),出血1例(1.33%);两组无明显差异(P0.05)。结论:吡拉西坦联合胞磷胆碱能改善急性脑梗死的认知功能和神经功能,其机制可能与调节细胞诱导因子Caspase-3和HIF-1α的表达水平相关。

Effects of Piracetam Combined with Citicoline on Cognitive and Neurological Functions in Patients with Acute Cerebral Infarction

ABSTRACT Objective: To study the effect of piracetam combined with citicoline on cognitive and neurological functions in patients with acute cerebral infarction. Methods: 150 patients with acute cerebral infarction from January 2014 to January 2018 were randomly divided into two groups. The control group was treated with piracetam, and the observation group was treated with piracetam combined with citicoline. Using the National Institutes of Health Stroke Scale (NIHSS), the Montreal Cognitive Assessment Scale (Mo CA), and the Activities of Daily Living (ADL) rating scale, coomparison of neurological function, cognitive function and daily living ability before and after treatment in the two groups. Results: In the observation group, 15 cases were basically cured, 30 cases were markedly effective, 26 cases were effective, 4 cases were ineffective and 1 case was deteriorated. The total effective rate was 94.67%, which was higher than that in the control group (P<0.05). After treatment, the ADL, Mo CA and NHISS scores of the two groups increased significantly, and the ADL, MoCA and NHISS scores of the observation group were significantly better than those of the control group (all P<0.05). After treatment, the levels of serum Caspase-3 and HIF-1alpha in two groups were significantly decreased, and the levels of serum Caspase-3 and HIF-1alpha in the observation group were lower than those in the control group (all P<0.05). The control group had 1 case of retching (1.33%), 2 cases of nausea (2.67%), 1 case of headache (1.33%) and 1 case of dizziness (1.33%), the observation group had 1 case of retching (1.33%), 1 case of nausea (1.33%), 1 case of headache (1.33%) and 1 case of haemorrhage (1.33%), there was no difference between the two groups (P>0.05). Conclusion: Piracetam combined with citicoline can significantly improve cognitive and neurological functions in patients with acute cerebral infarction. Miracles may be related to the expression of Caspase-3 and HIF-1a.