尤瑞克林联合胞磷胆碱钠治疗卒中后认知障碍患者的临床研究OA

Objective To investigate the clinical efficacy and safety of urinary kallidinogenase for injection combined with citicoline sodium capsules in the treatment of patients with post-stroke cognitive impairment(PSCI).Methods PSCI patients admitted to our hospital were divided into control group and treatment group according to the treatment method.Patients in the control group were orally administered citicoline sodium capsules,0.2 g each time,tid;patients in the treatment group were additionally given urinary kallidinogenase for injection,0.15 PNA Unit+normal saline 100 mL intravenous drip for 30 min,qd,on the basis of the control group,and both groups were continuously treated for 8 weeks.The clinical efficacy,cerebral blood flow perfusion,hemorheology,levels of nerve injury markers,electrophysiological parameters,clinical scores,and safety evaluation were compared between the two groups.Results A total of 96 cases were enrolled,with 49 cases in the treatment group and 47 cases in the control group.The total clinical effective rates of the treatment group and the control group were 89.80％(44 cases/49 cases)and 72.34％(34 cases/47 cases),respectively,and the difference was statistically significant(P＜0.05).After treatment,the middle cerebral artery end-diastolic minimum blood flow velocity(Vmin)of the treatment group and the control group was(10.05±1.86)and(9.17±1.65)cm·s-1,respectively;the mean blood flow volume(Qmean)was(12.67±2.08)and(11.51±1.92)cm·s-1,respectively;the serum brain-derived neurotrophic factor(BDNF)level was(15.24±2.59)and(13.76±2.24)μg·L-1,respectively;the P300 amplitude was(7.86±0.94)and(7.43±0.87)μV,respectively;the resistance index(RI)was(0.51±0.07)and(0.55±0.09),respectively;the whole blood high-shear viscosity(HBV)was(5.24±0.83)and(5.69±1.01)m·Pa·s,respectively;the fibrinogen(FIB)was(3.14±0.52)and(3.40±0.64)g·L-1,respectively;the serum neuron-specific enolase(NSE)was(7.35±1.23)and(8.07±1.44)μg·L-1,respectively;the visinin-like protein-1(VILIP-1)was(321.72±53.18)and(348.64±60.86)ng·L-1,respectively;the P300 latency was(334.59±21.57)and(346.25±23.63)ms,respectively;the Montreal Cognitive Assessment(MoCA)score was(26.13±3.71)and(23.73±3.24)points,respectively;the Mini-Mental State Examination(MMSE)score was(27.19±3.85)and(25.06±3.42)points,respectively;and the Stroke-Specific Quality of Life(SS-QOL)score was(79.65±9.83)and(74.52±10.34)points,respectively.The differences between the two groups in the above indicators were all statistically significant(P＜0.05,P＜0.01,P＜0.001).In the treatment group,1 case of hypotension,2 cases of infusion site redness and swelling,and 2 cases of nausea were observed;only 2 cases of nausea occurred in the control group.The total incidence of adverse reactions in the treatment group and the control group was 10.20％(5 cases/49 cases)and 4.26％(2 cases/47 cases),respectively,and the difference was not statistically significant(P＞0.05).Conclusion Urinary kallidinogenase for injection combined with citicoline sodium capsules in the treatment of PSCI patients has definite efficacy,can effectively improve cerebral blood flow perfusion and hemorheological status,alleviate nerve injury,promote the normalization of electrophysiological activity,significantly improve patients' cognitive function and daily living ability,and has high safety.