丹参多酚酸治疗合并无症状性心肌缺血的急性脑梗死疗效及安全性研究

发布时间：2018-03-21 19:33

本文选题：脑梗死　切入点：丹参多酚酸　出处：《吉林大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究背景:随着人们日常生活活动方式的改变以及老年人口的逐年增长,脑梗死在我国当今疾病谱中所占的比例越来越大。临床中合并无症状性心肌缺血的脑梗死患者和单纯脑梗死患者相比,其神经缺损症状和日常生活活动能力的恢复更差。目前对于丹参多酚酸的研究主要集中在药理作用及脑梗死临床疗效方面,对于其治疗合并无症状性心肌缺血的急性脑梗死患者临床疗效及安全性的研究较少。研究目的:研究丹参多酚酸对合并无症状性心肌缺血的急性脑梗死患者神经功能缺损程度、日常生活活动能力、ST段下移幅度的恢复作用以及其临床安全性。研究方法:选取吉林大学第一医院二部神经内科于2015年3月~2016年10月住院的急性脑梗死患者300例,其中合并无症状性心肌缺血的患者200例,不合并无症状性心肌缺血的患者100例。将合并无症状性心肌缺血的脑梗死患者平均分成两组,一组为心肌缺血用药组,另一组为心肌缺血对照组;将不合并无症状性心肌缺血的100例患者归为非心肌缺血用药组。治疗前对300例患者行一般资料收集、NIHSS评分、ADL评分及24小时动态心电图检查。用药治疗2周后再对所有患者行NIHSS评分,复查24小时动态心电图并总结治疗过程中出现的不良反应情况。治疗后3个月进行电话随访评估NIHSS评分和ADL评分。研究结果:1.心肌缺血用药组和心肌缺血对照组比较,其2周后的脑梗死疗效比较,差异有统计学意义(P0.05);其2周后的NIHSS评分及3个月后的NIHSS评分、ADL评分比较,差异均有统计学意义(P0.05)。2.治疗2周后,心肌缺血用药组和心肌缺血对照组ST段下移幅度比较,差异有统计学意义(P0.05)。3.心肌缺血用药组和非心肌缺血用药组比较,其2周后的脑梗死疗效比较,差异无统计学意义(P0.05);其2周后NIHSS评分及3个月后NIHSS评分、ADL评分比较,差异无统计学意义(P0.05)。4.三组不良反应均较少,且差异无统计学意义(P0.05)。结论:1.丹参多酚酸可以明显减轻合并无症状性心肌缺血的急性脑梗死患者的神经缺损症状,提高其日常生活活动能力,改善其不良预后。2.丹参多酚酸能降低合并无症状性心肌缺血的急性脑梗死患者的ST段下移幅度,改善心肌缺血程度。3.丹参多酚酸在临床应用中安全性好,副作用少,具有很好的临床应用前景。
[Abstract]:Background: with the change of people's daily life style and the increase of the elderly population year by year, The proportion of cerebral infarction in the disease spectrum of China is increasing. Compared with the patients with simple cerebral infarction, the patients with asymptomatic myocardial ischemia in clinic have more and more cerebral infarction. The recovery of neurological deficit symptoms and activities of daily living is worse. At present, the study of salvia miltiorrhiza polyphenolic acid is mainly focused on pharmacological effects and clinical efficacy of cerebral infarction. The clinical efficacy and safety of Salvia miltiorrhiza polyphenolic acid in the treatment of acute cerebral infarction complicated with asymptomatic myocardial ischemia were few. Objective: to study the degree of neurological impairment in patients with acute cerebral infarction complicated with asymptomatic myocardial ischemia by salvia miltiorrhiza (Salvia miltiorrhiza). Effects of activity of Daily living (ADL) on the recovery of St segment depression and its clinical safety methods: 300 patients with acute cerebral infarction were selected from the Department of Neurology, Department of Neurology, first Hospital of Jilin University, from March 2015 to October 2016. Among them, 200 patients with asymptomatic myocardial ischemia and 100 patients without asymptomatic myocardial ischemia were divided into two groups. The other group was myocardial ischemia control group. 100 patients without asymptomatic myocardial ischemia were classified as non-myocardial ischemia group. Before treatment, 300 patients were examined with general data collection, NIHSS score, ADL score and 24 hour ambulatory electrocardiogram. All patients were assessed with NIHSS, To review 24 hour ambulatory electrocardiogram (ECG) and to summarize the adverse reactions in the course of treatment. After 3 months of treatment, the NIHSS score and ADL score were evaluated by telephone. The results of the study were as follows: 1. Comparison between the medication group of myocardial ischemia and the control group of myocardial ischemia. There were significant differences in the curative effect of cerebral infarction after 2 weeks, the NIHSS scores after 2 weeks and the NIHSS scores after 3 months. The differences were statistically significant after 2 weeks of treatment, 2 weeks after treatment, 2 weeks after treatment, 2 weeks after treatment, 2 weeks after treatment, 2 weeks after treatment, 2 weeks after treatment, 2 weeks after treatment, there were significant differences in the efficacy of cerebral infarction. There was a significant difference in St segment depression between myocardial ischemia medication group and myocardial ischemia control group (P 0.05. 3). The therapeutic effect of myocardial ischemia treatment group was compared with that of non myocardial ischemia treatment group after 2 weeks of cerebral infarction. The difference was not statistically significant (P 0.05), but there was no significant difference in the NIHSS score after 2 weeks and the NIHSS score after 3 months. The adverse reactions in the three groups were less than those in the control group. Conclusion 1. Salvia miltiorrhiza polyphenolic acid can significantly reduce the neurological deficit in patients with acute cerebral infarction complicated with asymptomatic myocardial ischemia, and improve their activities of daily living. 2. Salvia miltiorrhiza polyphenolic acid can reduce St segment depression and improve myocardial ischemia degree in patients with acute cerebral infarction complicated with asymptomatic myocardial ischemia .3.Salvia polyphenolic acid has good safety and less side effects in clinical application. It has a good prospect of clinical application.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.33

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