论文部分内容阅读
[目的]探讨马来酸依那普利叶酸片联合亚低温对伴H型高血压缺血性脑卒中患者临床相关指标的影响.[方法]选择2015年1月至2016年1月本院收治的88例伴H型高血压缺血性脑卒中患者作为研究对象,采用随机数表法分将其为对照组(亚低温+马来酸依那普利片)和观察组(亚低温+马来酸依那普利叶酸片),各44例,疗程均为3个月.疗程结束后监测动态血压变化,治疗前后检测血浆同型半胱氨酸(Hcy)、IL-24、血小板α颗粒膜蛋白-140(GM P-140)、血小板源性生长因子(PDGF)、血管内皮功能[ET-1、一氧化氮(NO)];应用美国国立研究院卒中量表(NIHSS)和改良 Rankin量表(mRS)评估近期神经功能缺损及预后.[结果]观察组治疗后24hSBP、24hDBP、日间SBP、日间DBP、夜间SBP、夜间DBP均低于对照组,差异有统计学意义(P <0.05);观察组治疗后Hcy、PDGF、GMP-140、ET-1水平低于对照组,IL-24、NO高于对照组,差异有统计学意义(P <0.05);观察组治疗后NIHSS评分明显低于对照组,mRS≥2分所占比例为70.45% 明显高于对照组的47.73%,差异有统计学意义(P <0.05).[结论]应用马来酸依那普利叶酸片辅助亚低温治疗伴 H型高血压缺血性脑卒中,可降低患者血压、Hcy水平,还可抑制血小板异常活化,改善血管内皮功能,减轻神经功能缺损,改善近期预后.“,”[Objective]To investigate the effect of folic acid tablets of enalapril maleate combined with mild hy-pothermia on clinical indexes in patients with H type hypertensive ischemic stroke.[Methods]From January 2015 to January 2016,88 patients with H type hypertensive ischemic stroke were selected.The patients were divided in-to control group(mild hypothermia enalapril maleate tablet)and observation group(44 cases each for 3 months) by random number method.After the course of treatment,the changes of ambulatory blood pressure,plasma ho-mocysteine,IL-24,platelet α granule membrane protein -140(GM P-140),platelet derived grow th factor (PDGF),endothelial function[ET-1,nitric oxide],vascular endothelial function were detected before and after treatment.NIHSS and modified Rankin scale were used to evaluate the recent neurological impairment and progno-sis.[Results]The levels of 24hSBP,24hDBP,daytimeSBP,daytimeDBP,nocturnal SBP and nocturnal DBP in the observation group were significantly lower than those in the control group(P <0.05).After treatment,the level of Hcy,PDGF,GMP-140,and IL-24 and NO were higher than those of the control group,and the difference was statistically significant(P < 0.05).The NIHSS score in the observation group was significantly lower than that in the control group after treatment.The proportion of mRS ≥ 2 was 70.45%,which was significantly higher than that of the control group(47.73%,P < 0.05).[Conclusion]Folic acid tablets of enalapril maleate combined with mild hypothermia on clinical indexes in patients with H type hypertensive ischemic stroke can lower the level of Hcy in patients with blood pressure.It can also inhibit abnormal platelet activation,improve vascular endothelial function,alleviate neurological deficit and improve short-term prognosis.