急性脑梗死患者应用长春西汀片的临床疗效观察

摘要

Objective To investigate the effect of vinpocetine tablets in the treatment of patients after the onset of acute cerebra1 infarction.Methods One hundred patients with acute cerebral infarction were enrolled.Seven days after the basic treatment,the patients were randomly divided into the treatment group and control group.In the treatment group,patients were treated with 5mg vinpocetine tablets orally three times a day for 90 days,and those in the control group received placebo tablets.The outcomes were evaluated according to National Institute of Heath Stroke Scale(NIHSS),modified Rankin Scale(mRS), Barthel index(BI),Mini-mental State Examination (MMSE),hemorheological changes and superoxide Dismutase(SOD)and malondialdehyde(MDA)before and after the therapy.Results During the follow-up,five patients were dropped,ninety-five patients were still remalned in this study.In the treatment group,the NIHSS(1.82 ±1.49),mRS(0.79 ±0.70),BI(91.24 ±9.21),MMSE(26.50 ±4.53),and the total effective rate was significant higher than the control group(P <0.05).The hemorheology indexes of the treatment group were significantly better than those of the control group(P <0.05).MDA of the treatment group was declined and SOD was increased,though the difference was insignificant(P >0.05). No serious adverse events were observed.Conclusion Our results confirmed the beneficial effects of vinpocetine tablets on patients after the onset of cerebral ischemic stroke.%目的：观察急性脑梗死后应用长春西汀片的临床疗效。方法符合入组标准的100例急性脑梗死患者，经过7天基础治疗后随机分为长春西汀片治疗组和对照组。长春西汀片治疗组患者口服长春西汀片治疗90天，对照组采用安慰剂治疗，比较分析两组患者治疗前后神经功能缺损程度（NIHSS）、改良 Rankin 量表（mRS）、Barthel 指数（BI）、简易精神状态检查表（MMSE）、血液流变学指标改变情况、超氧化物歧化酶（SOD）、丙二醛（MDA）及临床有效率等指标，并监测药物不良反应。结果治疗90天后，治疗组 NIHSS 评分为（1．82±1．49）分、mRS 评分为（0．79±0．70）分、BI 评分为（91．24±9．21）分、MMSE 评分为（26．50±4．53）分，与对照组比较均显著改善，差异有统计学意义（P ＜0．05）。治疗组患者总有效率为95．7％，疗效显著，与对照组比较差异有统计学意义（P ＜0．05）。两组患者治疗前后血液流变学指标均明显改善，治疗组较对照组改善明显（P ＜0．05）。治疗组患者 SOD、MDA 在治疗90天后有所改善，但差异无统计学意义（P ＞0．05）。治疗期间未发现明显不良反应。结论脑梗死急性期后患者继续服用长春西汀片强化治疗，能有效促进神经功能恢复、改善日常生活能力、提高认知功能，并改善血液流变学指标，且无明显的不良反应，值得临床推广。