大豆磷脂对脑梗死治疗作用的研究

Curative effect of soybean lecithin on cerebral infarction

目的 探讨大豆磷脂对脑梗死的治疗效果。方法 将 5 42例发病 48h内、神经功能缺损积分在 31～ 35分的脑梗死患者分成 3组 :基础组 6 0例 ,脑梗死常规治疗 ;胞二磷胆碱组 12 2例 ,基础组药物加胞二磷胆碱治疗 ;大豆磷脂组 36 0例 ,基础组药物加大豆磷脂 30g/d分 3次口服治疗。患者分组后立即治疗 ,发病后开始用药时间不同 ,但都在 48h之内。疗程 2 8d。结果 疗程结束时 ,基础组、胞二磷胆碱组、大豆磷脂组的脑梗死体积分别为 7 6cm3 ± 2 9cm3 、7 3cm3 ± 3 1cm3 、6 4cm3 ±2 7cm3 ,3组相比F =7 371,P =0 0 0 0 7。基础组、胞二磷胆碱组与大豆磷脂相比 ,Dunnett检验 ,t值分别为 4 387和 3 96 9,均P <0 0 1;神经功能缺损积分减少分别为 14 2分± 10 9分、15 0分± 9 0分和 18 5分± 10 9分 ,药物和发病后开始用药时间对疗程后神经缺损积分作用的两因素析因设计资料方差分析 ,F药物 =6 2 5 0 ,P =0 0 0 2 1,F时间 =0 9417,P =0 42 0 1;以死亡、恶化、无效、进步、显著进步、基本痊愈为序 ,3组综合疗效结果Ridit分析 :Ridit值分别为 :0 40 0 3、0 4118和 0 5 46 5 ,χ2 =2 7 89,P <0 0 0 1。结论 大豆磷脂对急性期脑梗死有显著的治疗作用 ,机理可能是大豆磷脂减少了脑梗死时脑中磷脂?

Objective To investigate the clinical curative effect of soybean lecithin on cerebral infarction. Methods 542 patients with cerebral infarction within 48 h after the onset with the nervous fuction defect scores of 31～35 were divided into 3 groups: basic treatment group, 60 cases, with conventional treatment; citicoline group, 122 patients, with conventional treatment and citicoline; and soybean lecithin group, 360 patients, with conventional treatment and soybean lecithin 10 g tid. For all patients, treatment began sometime within 48 hours after the onset. The treatment course lasted 28 days. Results When the course was over, the infarct volumes in basic group?citicoline group, and soybean lecithin group, were 7.6 cm 3±2.9 cm 3, 7.3 cm 3±3.1 cm 3, and 6 4 cm 3±2.7 cm 3 respectively ( F =7.371, P =0.000 7). The basic group and citicoline group being compared with the soybean group by Dunnett test, t =4.387 and 3.969 respectively, P <0.01. The nervous function defect integral in the 3 groups decreased 14.2±10.93, 15.0±9.0, and 18.5±10.9 respectively. Two way analysis of variance of drug kind and beginning time of treatment showed the value of F in drugs as 6.250, P =0 002 1, and value of F in times as 0.941 7, P =0.420 1. In the order of death?deterioration?nonimprovement, improvement, significant improvement, and recovery, the Ridit values for the comprehensive curative effect in the 3 groups were 0.400 3, 0.411 8, and 0.546 5 respectively; χ 2=27.89, P <0.001. Conclusion Soybean lecithin is effective in treatment of acute cerebral infarction. The mechanism may be that soybean lecithin lowers the decrease of brain phospholipid content in brain ischemia.