硫辛酸注射液对脑梗死神经功能恢复及C-反应蛋白的影响
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摘要
目的观察硫辛酸注射液对脑梗死患者神经功能恢复及超敏C-反应蛋白(hs-CRP)动态变化的影响。方法选取2015年3月至2016年6月南阳市第三人民医院神经内科收治的确诊为脑梗死的126例患者作为研究对象,按照随机数表法分为对照组64例和观察组62例。对照组采用脑梗死常规治疗方法,观察组在对照组的治疗基础上加用硫辛酸注射液静脉滴注,每日1次,连用14 d。观察比较两组治疗7 d和14 d神经功能缺损程度NIHSS评分、日常生活质量Barthel指数并检测hs-CRP,观察两组不良反应发生情况。结果观察组总有效率83.87%,显著高于对照组的65.63%,差异有统计学意义(P<0.05);两组治疗前NIHSS评分和hs-CRP比较无明显差异;治疗后观察组NIHSS评分明显低于对照组(P<0.05); Barthel指数显著优于对照组(P<0.05); hs-CRP降低幅度显著大于对照组(P<0.01);不良反应发生率对照组为12.50%,观察组11.29%,组间比较差异无统计学意义(P>0.05)。结论硫辛酸注射液对脑梗死患者神经功能恢复方面效果显著,且具有抗炎作用,安全性良好。
Objective To observe the effect of lipoic acid injection on the recovery of nerve function and the dynamic changes of high-sensitive C-reactive protein (hs-CRP) in patients with cerebral infarction.Methods From March 2015 to June 2016,the patients with cerebral infarction were selected from the Department of Neurology,Nanyang third people 's Hospital. 126 patients were included in the study.According to the random number method,126 cases were divided into control group (n = 64) and observation group (n = 62). The control group was treated with routine treatment of cerebral infarction,and the observation group was treated with lipoic acid injection once a day for 14 d based on the treatment of the control group. The degree of nerve function defect were observed and compared between two groups after treatment 7 days and 14 days. The quality of daily life (Barthel) index and the detection of hs-CRP were measured,and the incidence of adverse reactions were observed. Results The total effective rate of the observation group was 83. 87%,which was significantly higher than that of the control group (65. 63%,P <0.05). There was no significant difference between the NIHSS score and hs-CRP before treatment in both groups. However,the NIHSS score of the observation group after treatment was significantly lower than that of the control group (P < 0.05),the Barthel index was significantly better than that of the control group (P <0.05),and the reduction of hs-CRP was more significant than the control group (P<0.01). The incidence of adverse reactions in control group and observation group were 12.50% and 11.29%,there was no significant difference between both groups (P > 0. 05).Conclusion The effect of lipoic acid injection on the recovery of nerve function in patients with cerebral infarction is significant, and it is antiinflammatory and safety.
Objective To observe the effect of lipoic acid injection on the recovery of nerve function and the dynamic changes of high-sensitive C-reactive protein (hs-CRP) in patients with cerebral infarction.Methods From March 2015 to June 2016,the patients with cerebral infarction were selected from the Department of Neurology,Nanyang third people 's Hospital. 126 patients were included in the study.According to the random number method,126 cases were divided into control group (n = 64) and observation group (n = 62). The control group was treated with routine treatment of cerebral infarction,and the observation group was treated with lipoic acid injection once a day for 14 d based on the treatment of the control group. The degree of nerve function defect were observed and compared between two groups after treatment 7 days and 14 days. The quality of daily life (Barthel) index and the detection of hs-CRP were measured,and the incidence of adverse reactions were observed. Results The total effective rate of the observation group was 83. 87%,which was significantly higher than that of the control group (65. 63%,P <0.05). There was no significant difference between the NIHSS score and hs-CRP before treatment in both groups. However,the NIHSS score of the observation group after treatment was significantly lower than that of the control group (P < 0.05),the Barthel index was significantly better than that of the control group (P <0.05),and the reduction of hs-CRP was more significant than the control group (P<0.01). The incidence of adverse reactions in control group and observation group were 12.50% and 11.29%,there was no significant difference between both groups (P > 0. 05).Conclusion The effect of lipoic acid injection on the recovery of nerve function in patients with cerebral infarction is significant, and it is antiinflammatory and safety.
引文
[1]吴江,贾建平,崔丽英.神经病学[M].2版.北京:人民卫生出版社,2010:158.
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[3]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
[4]李龙囡,王艳艳,尹彩娜,等.硫辛酸对高脂日粮小鼠脂代谢紊乱及氧化应激的调节作用[J].食品与生物技术学报,2013,32(6):608-614.
[5]全国第四届脑血管病学术会议.各类脑血管病诊断要点[J].中华神经科杂志,1996,29(6):379-380.
[6]吴江,贾建平,崔丽英.神经病学[M].2版.北京:人民卫生出版社,2010:153.
[7]苏占清,丁莹,陆倩,等.急性脑梗死病因病机临床初步分析[J].国际中医中药杂志,2013,35(12):1059-1061.
[8]Obrosova IG,Fathallah L,Liu E,et al.Early oxidative stress in the diabetic kidney:effect of DL-alpha-lipoic acid[J].Free Radic Biol Med,2003,34(2):186-195.
[9]李明锐.硫辛酸注射液对2型糖尿病合并脑梗死患者的临床疗效及血清炎性因子水平的影响[J].糖尿病新世界,2016,19(17):37-38.
[10]Denes A,Drake C,Stordy J,et al.Interleukin-1 mediates neuroinflammatory changes associated with diet-induced atherosclerosis[J].J Am Heart Assoc,2012,1(3):2-6.
[11]Williams KJ,Feig JE,Fisher EA.Rapid regression of atherosclerosis:insights from zhe clinical and experimental literature[J].Nat Clin Pract Cardiovasc Med,2008,5(2):91-102.
[12]Ormstad H,Aass H CD,Lund-S0rensen N,et al.Serum levels of cytokines and C-reactive protein in acute ischemic stroke patients,and their relationship to stroke lateralization,type,and infarct volume[J].J Neurol,2011,258(4):677-685.
[13]顾丽琴,沈云华.脑梗死患者血清超敏C反应蛋白的动态观察及其与病情关系的研究[J].临床和实验医学杂志,2013,12(20):1660-1661.
[14]黄耀宁,韦洪江.α-硫辛酸联合甲钴胺治疗糖尿病周围神经病变的疗效及对氧化应激的影响[J].山东医药,2013,53(8):13-15.
[15]王吾勇.硫辛酸注射液联合甲钴胺治疗急性脑梗死疗效观察[J].中国热带医学,2014,14(3):371-373.
[16]李敏.丁苯酞对急性脑梗死疗效及血清超敏C-反应蛋白的影响[J].医药论坛杂志,2015,36(6):155-156.
[2]李学全,李文敏.依达拉奉联合血塞通治疗急性脑梗死患者的疗效观察[J].中国基层医药,2011,18(20):2790-2791.
[3]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
[4]李龙囡,王艳艳,尹彩娜,等.硫辛酸对高脂日粮小鼠脂代谢紊乱及氧化应激的调节作用[J].食品与生物技术学报,2013,32(6):608-614.
[5]全国第四届脑血管病学术会议.各类脑血管病诊断要点[J].中华神经科杂志,1996,29(6):379-380.
[6]吴江,贾建平,崔丽英.神经病学[M].2版.北京:人民卫生出版社,2010:153.
[7]苏占清,丁莹,陆倩,等.急性脑梗死病因病机临床初步分析[J].国际中医中药杂志,2013,35(12):1059-1061.
[8]Obrosova IG,Fathallah L,Liu E,et al.Early oxidative stress in the diabetic kidney:effect of DL-alpha-lipoic acid[J].Free Radic Biol Med,2003,34(2):186-195.
[9]李明锐.硫辛酸注射液对2型糖尿病合并脑梗死患者的临床疗效及血清炎性因子水平的影响[J].糖尿病新世界,2016,19(17):37-38.
[10]Denes A,Drake C,Stordy J,et al.Interleukin-1 mediates neuroinflammatory changes associated with diet-induced atherosclerosis[J].J Am Heart Assoc,2012,1(3):2-6.
[11]Williams KJ,Feig JE,Fisher EA.Rapid regression of atherosclerosis:insights from zhe clinical and experimental literature[J].Nat Clin Pract Cardiovasc Med,2008,5(2):91-102.
[12]Ormstad H,Aass H CD,Lund-S0rensen N,et al.Serum levels of cytokines and C-reactive protein in acute ischemic stroke patients,and their relationship to stroke lateralization,type,and infarct volume[J].J Neurol,2011,258(4):677-685.
[13]顾丽琴,沈云华.脑梗死患者血清超敏C反应蛋白的动态观察及其与病情关系的研究[J].临床和实验医学杂志,2013,12(20):1660-1661.
[14]黄耀宁,韦洪江.α-硫辛酸联合甲钴胺治疗糖尿病周围神经病变的疗效及对氧化应激的影响[J].山东医药,2013,53(8):13-15.
[15]王吾勇.硫辛酸注射液联合甲钴胺治疗急性脑梗死疗效观察[J].中国热带医学,2014,14(3):371-373.
[16]李敏.丁苯酞对急性脑梗死疗效及血清超敏C-反应蛋白的影响[J].医药论坛杂志,2015,36(6):155-156.