目的 探討依折麥布片聯(lián)合注射用尤瑞克林治療老年急性腦梗死的效果。方法 選取陜西省核工業(yè)二一五醫(yī)院2023年10月－2024年10月收治的130例老年急性腦梗死患者，按照隨機(jī)數(shù)字表法將患者分為對(duì)照組和治療組，每組各為65例。對(duì)照組靜脈滴注0.15 PNA注射用尤瑞克林＋0.9%氯化鈉注射液100 mL，1次/d。治療組在對(duì)照組的基礎(chǔ)上口服依折麥布片，10 mg/次，1次/d。兩組均治療2周。比較兩組臨床療效、臨床評(píng)分、腦血流灌注情況、血清因子指標(biāo)。結(jié)果 治療后治療組的總有效率（92.31%）高于對(duì)照組的總有效率（75.38%，P＜0.05）。較治療前，兩組的改良Rankin量表（mRS）評(píng)分降低，簡(jiǎn)式Fugl-Meyer運(yùn)動(dòng)功能評(píng)分法（FMA）、簡(jiǎn)易智力狀態(tài)檢查量表（MMSE）評(píng)分升高（P<0.05）；治療組較對(duì)照組mRS評(píng)分更低，F(xiàn)MA、MMSE評(píng)分更高（P＜0.05）。較治療前，兩組治療后的血流平均通過(guò)時(shí)間（MTT）、峰值時(shí)間（TTP）縮短，局部腦血流量（CBF）、腦血容量（CBV）升高（P＜0.05）；治療組較對(duì)照組MTT、TTP更短，CBF、CBV更高（P＜0.05）。較治療前，兩組治療后的血清可溶性細(xì)胞黏附分子-1（sICAM-1）、基質(zhì)金屬蛋白酶-9（MMP-9）、白細(xì)胞介素-33（IL-33）、C反應(yīng)蛋白（CRP）水平降低（P＜0.05），治療組血清sICAM-1、MMP-9、IL-33、CRP水平較對(duì)照組更低（P＜0.05）。較治療前，兩組治療后的血清微小核糖核酸-132（miR-132）、微小核糖核酸-146a（miR-146a）、神經(jīng)營(yíng)養(yǎng)因子（NTF）水平升高，血清神經(jīng)元特異性烯醇化酶（NSE）、髓鞘堿性蛋白（MBP）水平降低（P＜0.05）；較對(duì)照組，治療組血清miR-132、miR-146a、NTF水平更高，血清NSE、MBP水平更低（P＜0.05）。結(jié)論 老年急性腦梗死患者使用依折麥布片聯(lián)合注射用尤瑞克林治療的療效顯著，與該治療方案有效調(diào)節(jié)炎癥指標(biāo)、miR-132、miR-146a和神經(jīng)因子水平，減輕機(jī)體炎癥，改善腦血流灌注、神經(jīng)、運(yùn)動(dòng)和認(rèn)知功能有關(guān)。

Objective To investigate the effect of Ezetimibe Tablets combined with Urinary kallidinogenase for injection in treatment of acute cerebral infarction in the elderly.Methods 130 Elderly patients with acute cerebral infarction admitted to Shaanxi Nuclear Industry 215 Hospital from October 2023 to October 2024 were divided into control and treatment group using a random number table method, with 65 cases in each group. The control group received intravenous infusion of 0.15 PNA injection with 100 mL of Urinary kallidinogenase for injection + 0.9% sodium chloride injection, once daily. The treatment group received oral Ezetimibe Tablets on the base of the control group, 10 mg/time, once daily. Both groups were treated for 2 weeks. The clinical efficacy, clinical scores, cerebral blood flow perfusion, and serum factor indicators were compared between two groups.Results After treatment, the total effective rate of the treatment group (92.31%) was higher than that of the control group (75.38%, P < 0.05). Compared with before treatment, the mRS scores of both groups were decreased, while the FMA and MMSE scores were increased (P < 0.05). The treatment group had lower mRS scores and higher FMA and MMSE scores than those in the control group (P < 0.05). Compared with before treatment, MTT and TTP of blood flow in both groups after treatment were decreased, but CBF and CBV were increased (P < 0.05). The treatment group had shorter MTT and TTP, and higher CBF and CBV than those in the control group (P <0.05). Compared with before treatment, the levels of sICAM-1, MMP-9, IL-33, and CRP in two groups were decreased after treatment (P < 0.05). The levels of sICAM-1, MMP-9, IL-33, and CRP in the treatment group were lower than those in the control group (P < 0.05). Compared with before treatment, the serum levels of miR-132, miR-146a, and NFT were increased in both groups after treatment, while the serum levels of NSE and MBP were decreased (P < 0.05). Compared with the control group, the treatment group had higher serum levels of miR-132, miR-146a, and NFT, and lower serum levels of NSE and MBP (P < 0.05).Conclusion The treatment of elderly patients with acute cerebral infarction using Ezetimibe Tablets combined with Urinary kallidinogenase for injection has significant therapeutic effects, which is related to the effective regulation of inflammatory indicators, miR-132, miR-146a, and nerve factor levels using this treatment regimen, reducing inflammation, improving cerebral blood flow perfusion, nerve, motor, and cognitive functions.

R971

陜西省核工業(yè)二一五醫(yī)院科研項(xiàng)目（215KYJJ-202212）