2021 年第 3 期 第 16 卷

奥拉西坦联合天麻素治疗急性脑出血的效果及对患者副代谢产物水平的影响

Effect of oxiracetam combined with gastrodin on acute cerebral hemorrhage and its influence on by-metabolites levels

作者：佟媛旭李岩刘晨魏雅丽王兴河

英文作者：Tong Yuanxu Li Yan Liu Chen Wei Yali Wang Xinghe

单位：首都医科大学附属北京世纪坛医院药物Ⅰ期临床试验研究室100038

英文单位：Phase I Clinical Trial Center Beijing Shijitan Hospital Capital Medical University Beijing 100038 China

关键词：脑出血；奥拉西坦；天麻素；兴奋性氨基酸；氧化代谢产物

英文关键词：Cerebralhemorrhage;Oxiracetam;Gastrodin;Excitatoryaminoacids;Oxidativemetabolite

• 摘要：

• 目的 观察奥拉西坦联合天麻素治疗急性脑出血的效果及对患者副代谢产物水平的影响。方法 选择2018年2月至2020年2月首都医科大学附属北京世纪坛医院收治的90例急性脑出血患者作为研究对象，按照随机数字表法分为观察组和对照组，每组45例。对照组患者在常规治疗的基础上给予奥拉西坦进行治疗，观察组患者在对照组的基础上联合天麻素进行治疗，均连续用药2周。对比2组患者治疗前后脑血肿体积、神经功能缺损评分和血尿酸、血糖、血脂水平以及兴奋性氨基酸和氧化代谢产物水平的差异。结果 治疗后，2组患者的脑血肿体积和神经功能缺损评分均较治疗前显著缩小/降低，且观察组小于/低于对照组［（8.6±2.0）ml比（13.2±4.3）ml、（9±4）分比（16±4）分］，差异均有统计学意义（均P<0.01）。治疗后，2组患者的血尿酸水平均较治疗前显著下降（均P<0.05），但2组间差异无统计学意义（P>0.05）；2组患者的总胆固醇、三酰甘油和低密度脂蛋白胆固醇水平均较治疗前显著下降、且观察组明显低于对照组，血糖均较治疗前升高、且观察组高于对照组，差异均有统计学意义（均P<0.01）。治疗后，2组患者兴奋性氨基酸和氧化代谢性产物水平均较治疗前降低，且观察组显著低于对照组，差异均有统计学意义（P<0.01或P<0.05）。2组患者的不良反应发生率差异无统计学意义（P>0.05）。结论 奥拉西坦联合天麻素治疗急性脑出血安全、有效，且可减少患者副代谢产物的形成。

• Objective To observe the effect of oxiracetam combined with gastrodin on patients with acute cerebral hemorrhage and its influence on body by-metabolites levels. Methods From February 2018 to February 2020, 90 cases of acute cerebral hemorrhage in Beijing Shijitan Hospital, Capital Medical University were selected. The patients were randomly divided into observation group and control group, with 45 cases in each group. Patients in the control group were treated with oxiracetam on the basis of conventional treatment, while patients in the observation group were treated with gastrodin on the basis of the control group, both groups were continuously treated for 2 weeks. The hematoma volume, neurological deficit score, serum uric acid, blood glucose, blood lipid levels, excitatory amino acids and oxidative metabolites were compared between the two groups before and after treatment. Results After treatment, the hematoma volumes and neurological deficit scores of the two groups were significantly reduced/decreased, and those of the observation group were less/lower than those of the control group［(8.6±2.0)ml vs (13.2±4.3)ml, (9±4) vs (16±4)］ (all P<0.01). After treatment, the levels of serum uric acid in the two groups were significantly lower than those before treatment(both P<0.05), but there was no significant difference in serum uric acid level between the two groups(P>0.05); the levels of total cholesterol, triglyceride and low-density lipoprotein cholesterol in the two groups were significantly lower than those before treatment, and the levels in observation group were significantly lower than those in control group; the blood glucose levels in both groups were higher than those before treatment, and the level in observation group was higher than that in control group(all P<0.01). After treatment, the levels of excitatory amino acids and oxidative metabolites in the two groups were lower than those before treatment, and those in the observation group were significantly lower than those in the control group(P<0.01 or P<0.05). There was no significant difference in incidence of adverse reactions between the two groups（P>0.05）. Conclusion Oxiracetam combined with gastrodin is safe and effective in the treatment of acute cerebral hemorrhage, and it can reduce the formation of by-metabolites in patients.