盐酸法舒地尔治疗急性脑梗死的临床疗效及对血液流变学和血浆内皮素-1的影响

Clinical efficacy of fasudil hydrochloride for treating acute cerebral infarction and its effect on hemorheology and plasma endothelin-1

目的探讨盐酸法舒地尔治疗急性脑梗死的临床疗效及对血液流变学和血浆内皮素-1的影响。方法选取2012年1月至2013年6月进行治疗的急性脑梗死患者88例,采用随机的方法分为研究组(n=44)和对照组(n=44),对照组患者给予常规治疗,研究组患者在对照组的基础上给予盐酸法舒地尔治疗,观察比较两组的疗效、血液流变学和血浆内皮素-1水平的变化。结果治疗后,对照组总有效率为79.55%,显著低于研究组的93.18%(χ2=8.318,P<0.05)。治疗后对照组红细胞沉降率、血细胞比容、纤维蛋白原、红细胞聚集指数、全血高切黏度分别为(23.32±8.01)mm/h、(39.56±3.56)%、(2.65±0.82)g/mL、(4.33±0.73)、(3.87±0.41)mPa·s明显高于研究组的(21.62±8.56)mm/h、(38.43±3.43)%、(2.45±0.82)g/mL、(4.14±0.76)、(3.65±0.40)mPa·s,差异有统计学意义(t=3.79,5.54,3.43,6.92,3.14,均P<0.05)。两组患者的血浆内皮素-1的水平经治疗后均显著下降,差异有统计学意义(t=5.24,7.62,均P<0.05),治疗后两组患者的血浆内皮素-1的水平比较差异有统计学意义(t=2.10,P<0.05)。结论盐酸法舒地尔治疗急性脑梗死具有较好的临床疗效,可以显著改善血液流变学状态,降低血浆内皮素-1水平,是治疗急性脑梗死的较佳选择。

Objective To evaluate the clinical efficacy of fasudil hydrochloride for treating acute cerebral in‐farction and its effect on hemorheology and plasma endothelin‐1 .Methods 88 cases of acute cerebral infarction in our hospital from January 2012 to June 2013 were selected and divided into the study group（n=44） and the control group （n=44） according to the random method .The control group was given the conventional therapy ,while on this basis the study group was given fasudil hydrochloride .The patient in the two group did not know oneself in which group . The effects and the changes of hemorheology and plasma endothelin‐1 were observed and compared between the two groups .Results The total effective rate after treatment in the control group was 79 .55% ,which was significantly lower than 93 .18% in the study group with statistical difference（χ^2 = 8 .318 ,P〈0 .05） .The erythrocyte sedimenta‐tion rate（ESR） ,hematocrit ,fibrinogen ,erythrocyte aggregation index and high shear viscosity of whole blood after treatment in the control group were （23 .32 ± 8 .01） mm/h ,（39 .56 ± 3 .56）% ,（2 .65 ± 0 .82） g/mL ,（4 .33 ± 0 .73） and （3 .87 ± 0 .41） mPa？ s respectively ,which were significantly higher than （21 .62 ± 8 .56） mm/h ,（38 .43 ± 3 .43）% ,（2 .45 ± 0 .82） g/mL ,（4 .14 ± 0 .76） and （3 .65 ± 0 .40） mPa？ s in the study group respectively ,the differences all showed statistical significance （t=3 .79 ,5 .54 ,3 .43 ,6 .92 ,3 .14 ,P〈0 .05） .The plasma levels of endo‐thelin‐1 after treatment in the two groups were significantly decreased （t=5 .24 ,7 .62 ,P〈0 .05） ,but the difference in the plasma endothelin‐1 level after treatment between the two groups was statistically significant （t=2 .10 ,P〈0 .05） .Conclusion Fasudil hydrochloride has better clinical effect for treating acute cerebral infarction ,can signifi‐cantly improve the hemorheologic state ,decrease the plasma endothelin‐1 level ,and is a better choice for treating a‐cute cerebral infarction .