β-七叶皂甙钠对急性脑梗死后脑水肿的疗效

Curative effect of β-sodium aescinate therapy on cerebral edema after acute cerebral infarction

目的观察β-七叶皂甙钠对急性脑梗死后脑水肿的疗效。方法将63例急性脑梗死患者随机分为对照组(30例)和治疗组(33例),均予以脑梗死常规治疗,治疗组加用β-七叶皂甙钠。根据脑梗死后1 d、5 d、14 d时MRI检查结果比较两组间各时间点脑梗死体积、脑组织水肿吸收率(ΔV)、各序列的信号强度比(SIR)、信号强度比相对变化率(ΔSIR)、相对表观弥散系数(rADC)。结果脑梗死后14 d,治疗组脑梗死灶体积显著小于梗死后1 d及对照组(P<0.05～0.01),脑组织ΔV显著高于对照组(P<0.05)。脑梗死后5d和14 d,治疗组T1WI的SIR显著高于对照组(均P<0.01),T2WI、Flair序列的SIR显著低于对照组(P<0.05～0.01)。脑梗死后5 d,治疗组弥散加权成像(DWI)序列的SIR显著低于对照组(P<0.01)。治疗组T1WI、T2WI、Flair序列的ΔSIR显著高于对照组(均P<0.05)。梗死后5 d,治疗组梗死区rADC显著高于对照组(P<0.05)。结论β-七叶皂甙钠治疗急性脑梗死后脑水肿有明显的效果。

Objective To observe the curative effect ofβ-sodium aescinate therapy on cerebral edema after acute cerebral infarction（ACI）. Methods Sixty-three ACI patients were divide into control group （30 cases） and therapy group （33 cases） randomly, and all of the patients received ACI conventional treatment. The therapy.group added β-sodium aescinate therapy. According to the results of MRI after ACI onset 1 d, 5 d and 14 d, the infarct volume, edema absorptivity （AV） of brain tissue, signal intensity rate （SIR） of each sequence, relative change rate of SIR （ASIR） and relative apparent diffusion coefficient （rADC） were compared between the two groups. Results At 14 d after ACI, the infarct volume in therapy group was significantly smaller than 1 d after ACI and control group （ P 〈 0. 05 - 0. 01 ）, the AV of brain tissue was significantly higher than control group （ P 〈 0. 05 ）. At 5 d and 14 d after ACI onset, SIR of TtWI in therapy group were significantly higher than control group（ all P 〈 0. 001 ） , SIR of T2WI and Flair sequence were significantly lower than control group（ P 〈 0. 05 -0.01 ）. At 5 d after ACI, SIR of diffasion weighted imaging （DWI） sequence in therapy group was significantly lower than control group（ P 〈 0. 01 ）. ASIR of T1 WI, T2 WI and Flair sequence in therapy group were significantly higher than control group （ all P 〈 0. 05 ）. The rADC of infarct region in therapy group was significantly higher than control group at 5 d after ACI （ P 〈 0. 05 ）. Conclusion β-sodium aescinate has a significant therapeutic effect on cerebral edema after ACI.