超早期脑梗死溶栓治疗联合应用依达拉奉后神经功能缺损症状的临床观察

Clinical observation of neurological deficit symptoms after combined application of ultra-acute cerebral infarction thrombolytic therapy and edaravone

目的观察超早期脑梗死溶栓治疗联合应用新型自由基清除剂依达拉奉的神经功能缺损症状情况。方法选择69例入我院的超早期脑梗死患者,随机分为重组组织型纤溶酶原激活剂(rt-PA)溶栓联合自由基清除剂依达拉奉治疗组(35例)和单独使用rt-PA溶栓治疗组(34例),比较治疗15 d、30 d和90 d时的美国国立卫生院卒中量表评分(NIHSS)。结果联合溶栓组治疗后15 d时NIHSS评分0-1分28.6%(10/35)与单纯溶栓组17.6%(6/34)比较有统计学意义(P<0.05);30 d时分别为34.3%(12/35)和23.5%(8/34),比较有显著性意义(P<0.05);90 d时分别为42.9%(15/35)和23.5%(8/34),比较有也显著性意义(P<0.05)。两组15 d、30 d和90 d的疗效差异有统计学意义。结论超早期脑梗死溶栓治疗联合应用新型自由基清除剂依达拉奉的能够更有效地改善病人的神经功能缺损症状。

Objective To discuss the clinical significance ofdetectation of plasma fibrinogen （Fg）, antiprothrombin-Ⅲ （AT-Ⅲ）, activated partial thromboplastin time （APTT） and plasma prothrombin time （PT） of a patient with cerebral infarction in the acute phase. Methods 98 cases with acute cerebral infarction were divided into two groups： one with progressive cerebral infarction and the other with complete cerebral infarction. They were treated by anticoagulants and routine medicine. The changes of the patients＇ Fg, AT-Ⅲ, APTT and PT before and after the treatment were monitored. Results As for the group with progressive cerebral infarction, the patients＇ Fg increased and AT-Ⅲ reduced; the differences were significant. As for the group with complete cerebral infarction, the aforementioned blood coagulation factors were normal without significant differences. After the group with progressive cerebral infarction was injected with low molecular weight heparin calcium, the content of Fg could be reduced effectively and the content of AT-Ⅲ could be increased. Conclusions In the acute phase of the progressive cerebral infarction, the coagulation function is abnormal; the corresponding treatment has clinical significance for the progressive cerebral infarction and can enhance the recovery rate and reduce the disability rate; however, it has no clinical significance for the complete cerebral infarction in the acute phase.