张翠
(新泰市第二人民医院 山东新泰 271200)
摘要:目的:分析研究乙酰谷酰胺联合依达拉奉治疗脑梗塞的疗效及药理机制。方法:时段:2017年04月至2020年01月,收集本院接治的脑梗塞患者开展研究,共收入90例,采取分别抽样法分组,即采纳常规治疗的对照组(n=45)和乙酰谷酰胺联合依达拉奉治疗的观察组(n=45),对比治疗效果、NIHSS评分、ADL评分。结果:分析治疗效果,和对照组(82.22%)相比,观察组(97.78%)更高,P<0.05。分析各项指标,治疗前,两组对比无统计学差异,P>0.05;治疗后和对照组NIHSS评分、ADL评分相比,观察组(10.38±1.35)、(75.33±8.47)更具优势,P<0.05。结论:实施乙酰谷酰胺联合依达拉奉治疗方案,对脑梗塞患者具有降低NIHSS评分、提高ADL评分的作用,疗效确切。
关键词:乙酰谷酰胺;依达拉奉;脑梗塞;治疗效果;NIHSS评分;ADL评分
近年来,脑梗塞的患病率日趋升高,该疾病也叫做缺血性脑卒中,患者局部脑组织软化坏死,产生智力障碍、半身不遂等症状,危害较大。在发病后,患者机体免疫功能紊乱,治疗以恢复神经功能、保护脑细胞为主,从而改善患者的神经症状[1]。给予脑梗塞患者乙酰谷酰胺、依达拉奉联合治疗,具有调节患者神经细胞代谢的作用,效果显著。本文择取本院接收的脑梗塞患者(时段:2017年04月至2020年01月),观察乙酰谷酰胺联合依达拉奉治疗脑梗塞的疗效及药理机制,现有以下内容。
1 资料和方法
1.1 一般资料
时段:2017年04月至2020年01月,选择本院接收的脑梗塞患者作为研究对象,符合研究内容者共计90例,对其临床资料展开回顾性分析,将其分为对照组(常规治疗)和观察组(乙酰谷酰胺联合依达拉奉治疗),各45例,其中对照组:女性患者例数为26,男性患者例数为19,患者年龄临界值64-78岁,均龄(71.66±2.36)岁。观察组:女性患者例数为27,男性患者例数为18,患者年龄临界值65-77岁,均龄(71.59±2.41)岁。两组基础资料相比P>0.05。
1.2 方法
对照组施行常规治疗,给予患者降压、吸氧、抗血小板等基础治疗,然后使用依达拉奉进行治疗,西安利君制药有限责任公司是依达拉奉的生产厂家,H20120042 是依达拉奉的国药准字,患者取30mg依达拉奉和0.9%氯化钠溶液100ml混合后实施静脉滴注,滴注时间控制在30min,1次/d,共治疗14d[2]。
观察组施行乙酰谷酰胺联合依达拉奉治疗,依达拉奉的使用方法和使用剂量同对照组保持一致,华润双鹤药业股份有限公司是乙酰谷酰胺的生产厂家,H11022104是乙酰谷酰胺的国药准字,取0.6g乙酰谷酰胺和5%葡萄糖溶液250ml充分混合后实施静脉滴注,每天1次,共治疗14d[3]。
1.3 观察指标
①分析治疗效果,有效率=显效+有效。②分析NIHSS评分、ADL评分。
1.4 统计学方法
脑梗塞患者所有数据利用SPSS20.0软件进行检验,NIHSS评分、ADL评分以形式()表述并实施独立样本t检验,治疗效果以[n/(%)]表述并实施检验,即有统计学意义,P<0.05。
2 结果
2.1 分析治疗效果
结果显示,和对照组(82.22%)相比,观察组(97.78%)更高,P<0.05。
表1:分析治疗效果[n/(%)]
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X8vhXqsB9nB9a93/3f0d1/3Yz1KlzF75XBsRb86vmWGev779wMVgVLwRkIrJADx1rwq+ebAmtr+R4QWDMQWCEHjrXgV0+EwJpbmu0JrLn93LKwGp6xHvCNz0IAABTk+tNSH1vqg2v5tZQTjeVnrFcFv3pwrAW/enCshaXgxcCvHhxrwa8eHGshsC4GfvXgWAt+9eBYC89YAQAAAsCMNSj41YNjLfjVg2MtLAUvBn714FgLfvXgWAuBdTHwqwfHWvCrB8daeMYKAAAQgO7A6vWfWLOxsbGxsUXdTg2sAAAA8BMCKwAAgCMEVgAAAEcIrAAAAI78B/+nFZJI7tzTAAAAAElFTkSuQmCC)
2.2 分析各项指标
结果显示,治疗前,两组对比无统计学差异,P>0.05;治疗后和对照组NIHSS评分、ADL评分相比,观察组更具优势,P<0.05。
表3:对比肾功能水平[]
![](data:image/png;base64,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)
3 讨论
脑梗塞是常见危急重症,治疗药物的选择直接影响着患者的预后质量,因此,相关医务人员应该合理选择药物,从而提高整体治疗效果。在治疗期间,使用依达拉奉和乙酰谷酰胺治疗方案,可改善脑组织受损程度,提高了用药有效率[4]。
本文研究可以发现,分析治疗效果,和对照组(82.22%)相比,观察组(97.78%)更高,P<0.05。由此可见,依达拉奉具有较高的亲脂性,患者使用后羟自由基含量减少,但是疗效仍存在局限性,可联合其他药物进行治疗,给予患者乙酰谷酰胺,能够快速通过血脑屏障,患者神经细胞功能明显改善,进一步提高了治疗效果[5]。治疗后,观察组NIHSS评分(10.38±1.35)、ADL评分(75.33±8.47)等优于对照组,P<0.05。可以发现使用依达拉奉、乙酰谷酰胺联合治疗,可促使患者神经功能恢复,协同用药效果显著。
综上所述,针对脑梗塞患者采用依达拉奉、乙酰谷酰胺联合治疗,可降低患者的神经功能缺损程度,进一步提高了治疗水平。
参考文献
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