无症状脑梗死干预治疗与急性缺血性脑卒中发生的相关性研究

The relationship between intervention therapy in patients with silent cerebral infarction and occurrence of ischemic stroke

目的研究无症状脑梗死患者干预性治疗与缺血性脑卒中发生的相关性。方法采用随机、对照的原则,将符合无症状脑梗死诊断标准的89例患者分为2组,对照组45例,只进行控制血糖、血压、血脂等危险因素的治疗;干预组44例,在控制危险因素的基础上进行干预治疗,包括阿司匹林抗血小板治疗、尼莫通保护脑细胞及中药治疗。治疗6个月后测定2组血液流变学指标。结果治疗后干预组各项指标均显著改善(P<0.05或P<0.01),对照组仅低切全血黏度降低(P<0.05)。干预组各项指标均明显低于对照组(P<0.05)。在3年随访期间,对照组发生症状性缺血性脑卒中21例(52.5%)高于干预组12例(29.3%),差异有统计学意义(P<0.05)。结论对无症状脑梗死患者进行干预性治疗,可望降低急性缺血性脑卒中的发生率。

Objective To investigate the relationship between intervention therapy in patients with silent cerebral infarction and the occurrence of ischemic stroke. Methods 89 patients with silent cerebral infarction were randoiuly divided into intervention therapy group （ n = 44） and control group （ n = 45）. The risk factors such as blood glucose; blood pressure and blood cholesterol levels were controlled in both groups. Additionally, a combination the rapy with aspirin, nimotop and Chinese traditional medicine were only given in intervention group, the hemorrheology indexes were measured after 6 months treatment. Results Six months later, the hemorrhoology results showed that the viscosity in patients with intervention was significantly lower than that in control patients （ P 〈 0.05 ）. During 3 years＇ follow up,21 cases of acute ischemic stroke occurred in control group, whereas only 12 cases in intervention group. There was statistical significance in the incidence of acute ischemic stroke between these two groups （control 52.5 % vs intervention 29.3 %, P 〈 0.05）. Conclusion It suggested that the patients with silent cerebral infarction could be beneficial from interventional therapy, and the incidence of acute ischemic stroke could be decreased obviously.