Objective To study the effect of Anisodine hydrobromide injection on cerebral vascular reserve function after acute massive cerebral infarction（ACI）. Methods A total of 60 patients were randomly divided into control group and observation group, in the control group, 30 patients were given routine treatment according to the “Chinese guideline for the diagnosis and treatment of acute ischemic stroke 2018”, thrombolysis and thrombectomy were not used in all patients, in the observation group, 30 patients were treated with Anisodine hydrobromide injection on the basis of routine treatment. The treatment dosage according to the instructions was 2mg/time, once a day and 14 days.The expression of VEGF, Ang-1, Tie-2 and FGF-2 were detected before and after treatment in all patients. The clinical effect, NIHSS score, the change of four sets test data and the safety of treatment were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group（P＜0.05）;Compared with the control group, the NIHSS score of the observation group was significantly lower than that of the control group（P＜0.05）; The expressions of VEGF, Ang-1, Tie-2 and FGF-2 in the observation group and the control group were significantly different（P＜0.05）.Conclusion Anisodine hydrobromide injection is effective and safe in the treatment of acute massive cerebral infarction, and can improve the cerebral vascular reserve function after cerebral infarction.

目的 观察盐酸纳美芬治疗重型颅脑损伤的效果,探讨其对重型颅脑损伤患者脑电双频指数(bispectral index,BIS)及预后的影响.方法 重度颅脑损伤患者102例,随机分为观察组52例和对照组50例,对照组给予常规治疗,观察组在常规治疗基础上给予盐酸纳美芬0.4～0.6 mg/d,静脉滴注,1次/d,共14d.比较2组患者入院第1天和治疗第14天时BIS值、格拉斯哥昏迷评分(Glasgow coma scale,GCS);治疗1个月时,评估2组患者治疗效果,比较ICU救治时间、格拉斯哥预后评分(Glasgow outcome scale,GOS)和病死率.结果 入院第1天,观察组患者BIS值(43.83±8.21)、GCS评分[(5.31±1.24)分]与对照组[42.18±7.84、(5.61±1.03)分]比较差异均无统计学意义(P＞0.05);治疗第14天时,观察组患者BIS值(58.49±9.64)、GCS评分[(11.81±1.04)分]均高于对照组[54.59±9.07、(9.15±1.21)分](P＜0.05),2组BIS值、GCS评分均高于入院第1天(P＜0.05).治疗1个月时,观察组ICU救治时间[(14.25±2.58)d]少于对照组[(16.68±3.19)d](t=-4.238,P＜0.001),GOS评分[(3.68±0.95)分]高于对照组[(3.13±0.87)分](t=3.046,P=0.003),病死率(23.07％)与对照组(28.00％)比较差异无统计学意义(x2=0.325,P=0.568).结论 早期应用大剂量盐酸纳美芬可保护重型颅脑损伤患者的神经功能,改善预后,缩短患者ICU救治时间.

Objective:To investigate the correlations of melanin concentration hormone (MCH) in cerebrospinal fluid (CSF) and serum with sleep disorder, memory dysfunction and prognoses in patients with cerebral ischemic stroke (CIS).Methods:One hundred elderly CIS patients, admitted to Department of Neurology, He'nan Provincial People's Hospital from June 2021 to January 2022 were enrolled as CIS group, and 50 subjects collected from Physical Examination of the same hospital during the same period were enrolled as control group. MCH levels in the CSF and serum were detected by ELISA. Sleep quality was assessed by polysomnography and Pittsburgh Sleep Quality Index (PSQI). Memory function was assessed by Rivermead Behavioral Memory Test 2 nd Edition (BMT-II). Prognoses were assessed by modified Rankin Scale (mRS) 3 months after discharge. The clinical data and MCH levels of the two groups were compared; the differences in MCH levels among CIS patients with different degrees of sleep disorder, and different memory functions and prognoses were compared. Correlations of MCH level and sleep parameters with RBMT-II scores in these CIS patients were analyzed. Results:Compared with that in the control group, the proportion of patients with hypertension in CIS group was significantly higher ( P<0.05). Compared with the control group ([42.39±16.11] pg/mL), the serum MCH level in CIS group ([36.89±15.19] pg/mL) was statistically lower ( P<0.05). In CIS patients, patients with mild or severe sleep disorder had significantly decreased CSF MCH level compared with patients without sleep disorder ( P<0.05), patients with severe sleep disorder had significantly decreased CSF MCH level compared with patients with mild sleep disorder ( P<0.05); patients with severe sleep disorder had significantly decreased serum MCH level compared with patients without sleep disorder ( P<0.05); CSF MCH level was negatively correlated with PSQI scores, sleep latency and wake frequency ( P<0.05), and positively correlated with percentage of rapid eye movement ( P<0.05); serum MCH level in CIS patients was negatively correlated with PSQI scores and wake frequency ( P<0.05). In CIS patients, the CSF and serum MCH levels in patients with memory dysfunction was significantly lower compared with those with normal memory function ( P<0.05); a positive correlation was noted between RBMT-II scores and CSF MCH level ( P<0.05). In CIS patients, patients with poor prognosis had statistically lower CSF and serum MCH levels compared with those with good prognosis ( P<0.05). Conclusion:The serum MCH level in CIS patients is significantly decreased, which is closely related to the occurrence of sleep disorder and memory dysfunction after stroke; and they further affects the prognoses.