目的 研究奧拉西坦聯(lián)合胞磷膽堿治療急性腦梗死的臨床效果。方法 選擇2018年3月—2019年10月新鄉(xiāng)市中心醫(yī)院收治的急性腦梗死患者104例為研究對象，采用隨機(jī)信封法將患者分為替格瑞洛聯(lián)合胞磷膽堿組（對照組）和奧拉西坦聯(lián)合胞磷膽堿組（治療組），每組各52例。對照組患者靜脈滴注胞磷膽堿注射液，0.5 g加入到100 mL 5%葡萄糖注射液中，1次/d；同時口服替格瑞洛片，90 mg/次，2次/d。治療組患者靜脈滴注胞磷膽堿注射液，0.5 g加入到100 mL 5%葡萄糖注射液中，1次/d；同時靜脈滴注奧拉西坦注射液，5 g加入到250 mL 5%葡萄糖注射液中，1次/d。兩組患者均連續(xù)治療3周。觀察兩組的臨床療效，比較兩組的神經(jīng)功能缺損（NIHSS）評分、蒙特利爾認(rèn)知評估量表（MoCA）評分，并比較兩組患者血清血管內(nèi)皮生長因子（VEGF）、神經(jīng)元特異性烯醇化酶（NSE）水平、炎癥因子水平。結(jié)果 治療后，兩組患者總有效率比較差異無統(tǒng)計(jì)學(xué)意義。治療后，兩組患者NIHSS評分較治療前明顯降低，MoCA評分明顯升高（P<0.05）；治療后治療組MoCA評分顯著高于對照組（P<0.05），治療后兩組NIHSS評分比較無統(tǒng)計(jì)學(xué)意義。治療后，兩組患者血清VEGF水平均較治療前明顯升高，NSE水平明顯降低（P<0.05）；且治療組患者血清VEGF水平明顯高于對照組，NSE水平明顯低于對照組（P<0.05）。治療后，兩組患者腫瘤壞死因子-α（TNF-α）、白細(xì)胞介素-6（IL-6）水平較治療前明顯降低（P<0.05）；且治療組患者TNF-α、IL-6水平降低幅度高于對照組（P<0.05）。結(jié)論 奧拉西坦聯(lián)合胞磷膽堿治療急性腦梗死具有較好的療效，可改善認(rèn)知功能，降低血清炎癥因子水平，具有一定臨床推廣應(yīng)用價值。

Objective To study the clinical effects of Oxiracetam Injection combined with Citicoline Sodium Injection in treatment of acute cerebral infarction. Methods Patients (104 cases) with acute cerebral infarction in Xinxiang Central Hospital from March 2018 to October 2019 were randomly divided into the ticagrelor combined with citicoline group (control group) and the oxiracetam combined with citicoline group (treatment group), and each group had 52 cases. Patients in the control group were iv administered with Citicoline Sodium Injection, 0.5 g added into 5% glucose solution 100 mL, once daily, and also po administered with Ticagrelor Tablets at the same time, 90 mg/time, twice daily. Patients in the treatment group were iv administered with Citicoline Sodium Injection, 0.5 g added into 5% glucose solution 100 mL, once daily, and also iv administered with Oxiracetam Injection at the same time, 0.5 g added into 5% glucose solution 250 mL, once daily. Patients in two groups were treated for 3 weeks. After treatment, the clinical efficacies were evaluated, and NIHSS score, MoCA score, the serum levels of VEGF, NSE, and inflammatory factors in two group were compared. Results After treatment, the total effective rates of two groups were not statistically significant. After treatment, NIHSS score of two groups was significantly lower than that before treatment, but MOCA score of two groups was significantly increased (P<0.05). After treatment, MOCA score of the treatment group was significantly higher than that of the control group (P<0.05), and NIHSS score of two groups was not statistically significant after treatment. After treatment, the serum level of VEGF in two groups was significantly higher than that before treatment, but the serum level of NSE was significantly decreased (P<0.05). And the serum level of VEGF the treatment group was significantly higher than that of the control group, but the serum level of NSE was significantly lower than that of the control group (P<0.05). After treatment, the levels of TNF-α and IL-6 in two groups were significantly lower than those before treatment (P<0.05), and the levels of TNF-α and IL-6 in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Oxiracetam Injection combined with Citicoline Sodium Injection has clinical curative effect in treatment of acute cerebral infarction, can improve cognitive function, and reduce the serum level of inflammatory factors.

R971

“十二五”國家科技支撐計(jì)劃項(xiàng)目（2011BAI08B02）