奥扎格雷钠治疗急性脑梗死临床疗效与经颅多谱勒对比研究评价

Clinical observation of sodium ozagrel in treatment with acute cerebral infarction and the detective changes of transcranial doppler

目的:研究注射用奥扎格雷钠治疗急性脑梗死疗效性与安全性及经颅多谱勒(TCD)检测的变化。方法:随机选择颈内动脉系统急性脑梗死患者60例为治疗组,静滴奥扎格雷钠80mg;60例为对照组,静滴丹参16mL,qd,持续2周。2组治疗前后观察神经功能缺损评分、临床疗效,做血小板计数、纤维蛋白原、凝血时间、凝血酶原时间检测,并通过TCD观察颅内血管平均血流速度(Vm)与血管搏动指数(PI)的变化和不良反应。结果:治疗组总有效率为93.33%,对照组总有效率为81.66%(P<0.05)。奥扎格雷钠治疗后神经功能缺损评分和生活能力等级较治疗前明显改善(P<0.01),优于对照组(P<0.05);血浆纤维蛋白原下降明显(P<0.01),而血小板计数、凝血时间、凝血酶原时间无明显变化;与治疗前相比,Vm明显增快、血管阻力明显降低(P<0.05)。结论:奥扎格雷钠是改善脑血流、治疗急性脑梗死的一种安全有效的药物、有临床推广应用价值。

OBJECTIVE To observe the curative effect and safety in treatment of acute cerebral infarction with sodium ozagrel. METHODS We selected 120 confirmed cases of acute cerebral infarction. The subjects were randomLy divided into two groups：the control group, there were 60 cases who were treated with normal saline 250 mL plus codanshen injection 16mL iv qd 14 d;the trial group,there were 60 cases who were treated with normal saline 250 mL plus ozagrel 80mg ivdrip qd 14 d. We judged the clinical neurologic function and defect degree before and after 14 d treatment according to the neurologic deficit score and coagulating function to analyse the curative effect. We explored their changes of the mean flow velocity （Vm） and the pulsating index （PI） of intracranial vascular through TCD. RESULTS Total effective rate of the trial group was 93.33%,the control group was 81.66% （P〈0. 05）. There was an apparent difference in fibrinogen between the trial group and the control group （P〈0. 01）. The post therapy＇s Vm was higher than the pretreatment＇s. The vascular resistance was lower than the pretreatment＇s （P〈0. 05）. CONCLUSION The sodium ozagrel can improve the cerebral blood stream and is an effective and safe medicine in the treatment of acute cerebral infarction.