环磷酰胺、秋水仙碱联合治疗急性脑梗塞病人的随机对照试验

Clinical Randomized Controlled Trial of Patients with Acute Cerebral Infarction Treated with Cyclophosphamide and Colchicine

目的：研究环磷酰胺、秋水仙碱作为抗炎药物治疗急性脑梗塞病人是否有效。方法：６４例急性脑梗塞病人随机分为试验组和对照组（各３２例）。对照组给予一般治疗，试验组在一般治疗的基础上静滴环磷酰胺０１～０２ｇ和口服秋水仙碱１ｍｇ，每天１次，共１０天。采用改良爱丁堡—斯堪的那维亚中风量表（ｍｏｄｉｆｉｅｄＥｄｉｎｂｅｒｇｈＳｃａｎｄｉｎａｖｉａｓｔｒｏｋｅｓｃａｌｅ，ｍＥＳＳ）及ＮＩＨ中风量表（ＮＩＨｓｔｒｏｋｅｓｃａｌｅ，ＮＩＨＳＳ）分于入院时、病后７天、１４天、１月、２月、３月进行神经功能缺损评分，用ＢａｒｔｈｅｌＩｎｄｅｘ（ＢＩ）分于病后１月、２月、３月进行日常生活活动评分。结果：病后１４天、１月、２月、３月试验组神经功能缺损评分显著低于对照组（Ｐ＜００５或Ｐ＜００１），２月、３月试验组显效率高于对照组（Ｐ＜００５）；２月、３月试验组ＢＩ评分高于对照组（Ｐ＜００５），基本独立及轻度依赖比率高于对照组（Ｐ＜００５）。结论：环磷酰胺、秋水仙碱作为抗炎药物治疗急性脑梗塞病人，能减轻病人神经功能缺损，提高病人独立生活能力。

Objective:To study the effects of cyclophosphamide and colchicine on patients with acute cerebral infarction.Method:Sixty four patients with acute cerebral infarction were divided into treatment group and control group(32 patients in each).The control group was given general therapy,and the cyclophosphamide 0 1～0 2g and colchicine l mg were given to the treatment group per day for 10 days besides the general therapy.The neurological functional defects at admission,day 14,month 1,2 and 3 were evaluate with modified Edinbergh Scandinavia stroke scale (mESSS)and NIH stroke scale(NIHSS),and the activity of daily living(ADL)at month 1,2 and 3 was evaluated with Barthel Index(BI).Results:Compared with those of the control group,the scores of mESS and NIHSS of the treatment group at day 14,month 1,2 and 3 were lower than those of the control group( P< 0 05 or P <0 01).The effectiveness,the scores of BI and the rate of almost independence and mild dependence of the treatment group at month 2 and 3 were higher than those of the control group( P <0 05).Conclusion:Cyclophosphamide and colchicine,as antiinflammatoly drugs,would reduce the neurological functional defects of patients with acute cerebral infarction and enhance ability of independence of the patients.