醒脑静注射液联合丁苯酞治疗大脑中动脉供血区梗死的临床观察

发布时间：2018-12-05 19:19

【摘要】：目的:探讨醒脑静注射液联合丁苯酞对大脑中动脉供血区梗死患者神经功能、认知功能、凝血功能、生活活动能力的影响及安全性。方法:选取2014年6月-2015年12月于武汉大学人民医院就诊的大脑中动脉供血区梗死患者106例为研究对象,按照随机数字表法分为对照组和观察组,各53例。除常规对症治疗外,对照组患者给予丁苯酞软胶囊0.2 g,po,tid;观察组患者在对照组基础上给予醒脑静注射液20 m L加至0.9%氯化钠注射液250 m L,ivgtt,qd。两组患者均持续治疗14 d。观察两组患者治疗前后神经功能[按美国国立卫生研究院卒中量表(NIHSS)和临床神经功能缺损评分标准(NFDS)评分]、认知功能[按蒙特利尔认知量表(Mo CA)和简易精神状态评价量表(MMSE)评分]、凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血浆纤维蛋白原(FIB)]、日常生活活动能力量表(BI)评分,并记录继发远隔损害和不良反应发生情况。结果:脱落病例共8例,其中对照组3例、观察组5例。治疗前,两组患者神经功能评分、认知功能评分、凝血功能指标、BI评分比较,差异均无统计学意义(P0.05)。治疗后,两组患者NIHSS、NFDS评分和FIB水平均较治疗前明显降低,且观察组明显低于对照组,差异均有统计学意义(P0.05);两组患者Mo CA、MMSE、BI评分均较治疗前明显升高,PT、APTT均较治疗前明显延长,且观察组明显高于或长于对照组,差异均有统计学意义(P0.05)。观察组患者的继发远隔损害发生率(11.3%)明显低于对照组(41.5%),差异有统计学意义(P0.05)。两组患者不良反应发生率比较,差异无统计学意义(P0.05)。结论:醒脑静注射液联合丁苯酞治疗大脑中动脉供血区梗死,可降低远隔损害发生风险,促进患者神经功能、认知功能恢复,改善凝血功能和生活活动能力,且安全性较高。
[Abstract]:Objective: to investigate the effect and safety of Xingnaojing injection combined with butyphthalide on the neurological function, cognitive function, coagulation function and living activity of patients with infarction in the middle cerebral artery (MCA). Methods: from June 2014 to December 2015, 106 patients with infarction in the middle cerebral artery (MCAA) were selected from Renmin Hospital, Wuhan University, and divided into control group (53 cases) and observation group (53 cases) according to random digital table method. In addition to routine symptomatic treatment, the patients in the control group were given butyphthalide soft capsule 0.2 g potid, and the patients in the observation group were given Xingnaojing injection 20 mL plus 0.9% sodium chloride injection 250 mL iv gttt QD on the basis of the control group. The patients in both groups were treated continuously for 14 days. To observe the neurological function of the two groups before and after treatment [according to the National Institutes of Health Stroke scale (NIHSS) and Clinical Neurologic deficit scoring Standard (NFDS)]. Cognitive function [according to Montreal Cognitive scale (Mo CA) and Mini-Mental State Assessment scale (MMSE)], Coagulation function Index [prothrombin time (PT),) activated partial thromboplastin time (APTT),)] Plasma fibrinogen (FIB), activity of daily living (ADL) scale (BI) score, secondary distant damage and adverse reactions were recorded. Results: there were 8 cases of shedding, including 3 cases in control group and 5 cases in observation group. Before treatment, there was no significant difference in neurological function score, cognitive function score, coagulation function index and BI score between the two groups (P0.05). After treatment, the NIHSS,NFDS score and FIB level of the two groups were significantly lower than those before treatment, and the observation group was significantly lower than the control group, the difference was statistically significant (P0.05). The Mo CA,MMSE,BI scores of the two groups were significantly higher than before treatment, PT,APTT were significantly longer than before treatment, and the observation group was significantly higher or longer than the control group, the difference was statistically significant (P0.05). The incidence of secondary distant damage in the observation group (11.3%) was significantly lower than that in the control group (41.5%), and the difference was statistically significant (P0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P0.05). Conclusion: Xingnaojing injection combined with butyphthalide can reduce the risk of distant damage, promote the recovery of nerve function, cognitive function, improve coagulation function and life ability, and is safe.
【作者单位】：天津医科大学基础医学院;武汉大学人民医院神经内科;
【分类号】：R743.3

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