降纤酶联用依达拉奉治疗急性脑梗死

Clinical Study of Edaravone-Defibrase Combination in Treatment of Acute Cerebral Infarction

目的:探讨依达拉奉联用降纤酶治疗急性脑梗死的临床疗效及安全性。方法:发病12 h内的急性脑梗死患者93例,随机分为A组46例和B组47例。A组患者用依达拉奉注射液(30 mg加入0.9%氯化钠液100 mL静脉滴注,2次/d,共14 d)和降纤酶(首剂量为15 U,以后隔日给予5 U,共4次,均加入0.9%氯化钠液250 mL,2～3 h内静脉滴注);B组患者仅用降纤酶治疗。治疗前后对患者进行欧洲脑卒中量表(ESS)神经功能缺损程度评分、日常生活能力(ADL)评分、急性生理功能和慢性健康状况评分(APACHE)II评分及C反应蛋白(CRP)测定,随访时间3个月。结果:治疗后14 d,2组患者的ESS、ADL、APACHE II和CRP较治疗前有显著改善,A组的各项指标优于B组;A组有效率(67.4%)显著高于B组(40.4%)(P<0.05);3个月病死率2组无显著差异(P>0.05);2组患者均无颅内出血发生,少数患者发生颅外出血,2组差异无统计学意义,所有病例无严重不良反应发生。结论:依达拉奉联用降纤酶治疗急性脑梗死安全、有效。

Objective：To investigate the efficacy and safety of edaravone-defibrase combination in treatment of acute cerebral infarction. Methods： The patients with acute cerebral infarction within 12 hours of stroke onset were divided randomly into two groups：group A（46 cases）and group B（47 cases）. Group A were treated with edaravone（30mg, twice a day, for 14 days）and de- fibrase（initial 15U, subsequent 5U on the 3th, 5th,7th,9th day） ;and group B were treated only with defibrase. The neurological deficit scores of European stroke scale（ESS）, activities of daily living（ADL）, acute physiology and chronic health evalution II （APACHE） II scores and C-reactive protein（CRP）level were evaluated before and after treatment;the efficacy was evaluated after the treatment. Results： After the 14th day treatment,there were significant difference of all the four variables（ESS,ADL, APACHE II and CRP）in two groups than before treatment,all the four variables of group A were better than group B;the efficient rate of group A（67.4 %）was higher than group B（40.4 % ） （P〈0.05） ;There was no significant difference for the mortality at 3 months between two groups（P〉0.05） ;There were several patients with extracranial hemorrhage and there was no significant difference between two groups（P〉0.05）,there was no intracranial hemorrhage in all patients;there was no severe adverse reaction in two groups. Conclusions： Edaravone-defibrase combination is effective and safe in treatment of acute cerebral infarction.