系列体感诱发电位评估低分子肝素治疗急性脑梗死

Evaluation of fraxiparine therapy on acute cerebral infarction by serial somatosensory evoked potentials

目的 通过系列体感诱发电位检查了解低分子肝素 (速避凝 )在急性脑梗死治疗中的疗效。方法 对 37例急性脑梗死患者在治疗前 ,治疗后 1周内 ,2周内 ,3周内共 4次作了经正中神经刺激短潜伏期体感诱发电位检查 ,记录了N2 0波的潜伏期和波幅 ,并对其中的 2 3例速避凝治疗者及 14例对照者进行对比研究。结果 脑梗死侧N2 0波的波幅在发病后 48h内已有明显降低 ,而潜伏期仅在 3周时稍有延长 ,且无显著统计学意义。速避凝治疗后 ,降低的N2 0波波幅有显著改善 ,而对照组则无变化。结论 速避凝治疗急性脑梗死改善了缺血半卵圆区微循环 ,保护了缺血后的脑功能 ,限制了梗死灶的扩大。我们认为体感诱发电位可以用来对治疗缺血性卒中的药物进行疗效评估。

Objective To evaluate the effectiveness of fraxiparine therapy on acute cerebral infarction by serial median nerve somatosensory evoked potentials (SEP). Methods 37 patients with acute cerebral infarction were divided into treatment and control groups and the latency and amplitude of N20 wave were recorded. Before treatment and at the first, second and third week after therapy,the results of treatment group were compared with those of control group. Results The amplitude of N20 wave recorded from the affected hemisphere was clearly diminished, however, the latency was slightly prolonged at the third week after onset of disease ( P >0.05). The reduced amplitude of N20 wave was remarkably improved after fraxiparine therapy,while that in the control group was unchanged. Conclusion Fraxiparine treatment improves the microcirculatory blood flow in the ischemic region, protects the postischemic brain function and limits the extension of infarcted foci. We believe that SEP measurements can be used for evaluation of effectiveness of therapeutic drugs in acute ischemic stroke. (Shanghai Med J, 2000,23∶650 652)