中分子羟乙基淀粉注射液治疗急性脑分水岭梗死的疗效观察

Observation of curative effects of medium molecular weight hydroxyethyl starch on treating acute cerebral watershed infarction

目的观察中分子羟乙基淀粉注射液治疗急性脑分水岭梗死（CWI）的疗效。方法随机将100例CWI患者分为中分子羟乙基淀粉注射液治疗组和对照组（每组50例）。两组患者均给予改善脑供血、抗血小板等脑梗死常规治疗,治疗组再予以中分子羟乙基淀粉注射液500 ml静脉滴注,每天1次,连续14 d。在治疗前、治疗后第7 d、14 d对两组患者进行临床神经功能缺损程度评分（NDS）、Barthel指数（BI）以及治疗后90 d进行改良Rankin量表（mRS）测评,比较疗效。结果治疗组治疗后第7 d、14 d NDS评分比治疗前及对照组明显降低（均P〈0.01）;BI比治疗前及对照组明显升高（均P〈0.01）;治疗后90 d,两组mRS评分的差异具有统计学意义（P〈0.01）;治疗组临床结局良好（mRS 0~1分）率（63.8%）明显高于对照组（22.9%）（P〈0.01）;治疗过程未见明显不良反应。结论中分子羟乙基淀粉注射液治疗CWI疗效显著,能减轻患者的神经功能缺损程度、改善预后,无明显不良反应。

Objective To observe the curative effects of medium molecular weight hydroxyethyl starch on treating acute cerebral watershed infarction（CWI）.Methods One hundred patients with CWI were randomly divided into medium molecular weight hydroxyethyl starch injection treatment group（n=50） and control group（n=50）.The patients in both groups were given conventional therapy of acute cerebral infarction including improvement of cerebral circulation,anti-platelet.Moreover,the treatment group was treated with hydroxyethyl starch 500 ml intravenous injection,once a day for 14 d.The curative effects was appraised by the score of nervous function deficit scale（NDS）,Barthel Index（BI）（before treatment,7 d,14 d after treatment） and modified rankin scale（mRS）（90 d after treatment）,and compared between the two groups.Results At 7 d,14 d after treatment,the scores of NDS in the treatment group were decreased significantly than those in the control group and before treatment（all P0.01）;the BI were increased significantly than those in the control group and before treatment（all P0.01）;at 90 d after treatment,the scores of mRS between the two groups had significant difference（P0.01）.The ratio of good clinical outcome（mRS score 0 to 1） of the treatment group（63.8%） was significantly higher than the control group（22.9%）（P0.01）.There was no adverse reaction during the course of treatment.Conclusion Medium molecular weight hydroxyethyl starch injection treating CWI has significantly effectual,which can reduce the degree of neurologic impairment,improve the prognosis and no significant adverse reaction.