吡拉西坦联合舒血宁注射液对高血压并脑梗死患者血液流变学及血清Hcy和hs-CRP水平的影响

doi:10.3969/j.issn.1006-6233.2022.02.032

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摘要 目的: 探讨吡拉西坦与舒血宁注射液联合治疗对高血压并脑梗死患者血液流变学和血清同型半胱氨酸(homocysteine,Hcy)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)水平的影响。方法: 选取2019年1月至2020年10月我院收治的86例高血压并脑梗死患者,采取简单随机分组分为联合组(n=43)和常规组(n=43)。常规组患者予以吡拉西坦治疗,联合组患者予以吡拉西坦联合舒血宁注射液治疗。观察两组患者治疗前后神经功能[美国国立卫生研究院卒中量表(NIHSS)]、认知功能[简易精神状态评价量表(MMSE)]、颈动脉超声指标[颈动脉内膜-中层厚度(IMI)、颈动脉斑块面积、颈动脉血流量]、血液流变学(血浆粘度、高切全血黏度、低切全血黏度、血细胞比容)以及血清Hcy、hs-CRP、神经元特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)、中枢神经特异蛋白(S100β)水平的变化情况。结果: 治疗3个月后,两组患者NIHSS评分低于治疗前,MMSE评分高于治疗前(P<0.05),IMI、颈动脉斑块面积小于治疗前,颈动脉血流量大于治疗前(P<0.05),且联合组各指标改善情况优于常规组(P<0.05);治疗3个月后,两组患者血浆粘度、高切全血黏度、低切全血黏度、血细胞比容以及血清Hcy、hs-CRP、NSE、MBP、S100β水平均较治疗前降低,且联合组各指标治疗前后差值均显著高于常规组(P<0.05)。结论: 吡拉西坦与舒血宁注射液联合治疗高血压并脑梗死可有效改善患者神经功能以及认知功能,抑制粥样硬化斑块形成,并降低血液黏度和炎症水平,有利于病情转归。

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关键词 ：高血压, 脑梗死, 吡拉西坦, 舒血宁注射液, 血液流变学

Abstract：Objective: To investigate the effect of piracetam combined with Shuxuening injection on hemorheology and levels of serum homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) in patients with hypertension complicated with cerebral infarction. Methods: A total of 86 patients with hypertension and cerebral infarction admitted to the hospital between January 2019 and October 2020 were selected and divided into combined group (n=43) and regular group (n=43) by simple random grouping. Patients in regular group were treated with piracetam, and patients in combined group were given piracetam combined with Shuxuening injection. The neurological function [National Institutes of Health Stroke Scale (NIHSS)], cognitive function [Mini-Mental State Examination(MMSE)], carotid artery ultrasound indicators [carotid artery intima-media thickness (IMI), carotid artery plaque area, carotid artery blood flow], hemorheology (plasma viscosity, high-shear whole blood viscosity, low-shear whole blood viscosity, hematocrit) and levels of serum Hcy, hs-CRP, neuron-specific enolase (NSE), myelin basic protein (MBP) and central nervous system specific protein (S100β) were observed in the two groups before and after treatment. Results: After 3 months of treatment, the NIHSS score of the two groups was lower than that before treatment while the MMSE score was higher than that before treatment (P<0.05), IMI and carotid artery plaque area were smaller than those before treatment, carotid artery blood flow was more than that before treatment (P<0.05), and the improvement status of the above indicators in combined group were better than those in regular group (P<0.05). After 3 months of treatment, the high-shear whole blood viscosity, low-shear whole blood viscosity, plasma viscosity, hematocrit and levels of serum Hcy, hs-CRP, NSE, MBP and S100β in the two groups were decreased compared with those before treatment, and the difference of each index before and after treatment in combined group were significantly higher than those in regular group (P<0.05). Conclusion: Piracetam combined with Shuxuening injection in the treatment of hypertension with cerebral infarction can effectively improve the neurological function and cognitive function, inhibit the atherosclerotic plaque formation and reduce blood viscosity and inflammation level, and it is beneficial to the outcomes of disease.

Key words： Hypertension Cerebral infarction Piracetam Shuxuening injection Hemorheology

基金资助:四川省卫生和计划生育委员会科研课题,(编号:19PJ1366)

通讯作者: 江海燕

引用本文:

江雪, 江海燕. 吡拉西坦联合舒血宁注射液对高血压并脑梗死患者血液流变学及血清Hcy和hs-CRP水平的影响[J]. 河北医学, 2022, 28(2): 331-336.
JIANG Xue, JIANG Haiyan. Effect of Piracetam Combined with Shuxuening Injection on Hemorheology and Levels of Serum Hcy and Hs-CRP in Patients with Hypertension Complicated with Cerebral Infarction. HeBei Med, 2022, 28(2): 331-336.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2022.02.032 或 http://www.hbyxzzs.cn/CN/Y2022/V28/I2/331

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