前列地尔治疗短暂性脑缺血发作的临床研究

Clinical study of alprostadil in treatment of transient ischemic attack

目的观察前列地尔治疗短暂性脑缺血发作的临床疗效。方法选择2011年1月—2014年5月在天津市武清区人民医院就诊的短暂性脑缺血患者100例,随机分为对照组和治疗组,每组各50例。对照组采用常规治疗,治疗组在常规治疗基础上静脉滴注前列地尔注射液,2 m L/次加生理盐水10 m L直接入小壶静脉滴注。两组均连续治疗15 d。观察两组的临床疗效,同时比较治疗前后两组凝血指标、血液黏度指数和血流动力学参数的变化。结果治疗后,对照组和治疗组的总有效率分别为82.0%、94.0%,两组总有效率比较差异有统计学意义(P<0.05)。治疗前后两组血小板计数(PLT)、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)差异均无统计学意义。治疗后,两组全血黏度、血浆黏度、纤维蛋白原、脑血管阻力(R)均较治疗前显著降低,两组最大血流速度(Vmax)、最小血流速度(Vmin)、平均血流速度(Vmean)、平均血流量(Qmean)均较治疗前显著升高,同组治疗前后差异有统计学意义(P<0.05),且治疗组这些观察指标的改善程度优于对照组,两组比较差异有统计学意义(P<0.05)。结论前列地尔治疗短暂性脑缺血发作具有较好的临床疗效,无明显副作用,具有高效、安全等优点,值得临床推广应用。

Objective To observe the effect of alprostadil in treatment of transient ischemic attack. Methods Patients（100 cases） with transient ischemic attack in the People＇s Hospital of Wuqing District in Tianjin from January 2011 to May 2014 were randomly divided into control and treatment groups, and each group had 50 cases. The patients in the control group were given conventional treatment. The patients in the treatment group were iv administered with Alprostadil Injection, 2 mL/time added in 10 mL physiological saline directly into a small pot of iv drip. Two groups were treated for 15 d. After treatment, the efficacy was evaluated, and the changes of blood coagulation indexes, viscosity indexes, and cerebrovascular hemodynamic parameters before and after treatment in two groups were compared. Results The efficacies in the control and treatment groups were 82.0% and 94.0%, respectively, and there were differences between two groups（P〈0.05）. After treatment, there was no statistically significant difference on PLT, PT, and APTT in the two groups. After treatment, the whole blood viscosity, plasma viscosity, fibrinogen, and cerebral vascular resistance（R） in two groups were significantly reduced, and the Vmax, Vmin, Vmean, and Qmean in two groups were significantly increased, and the difference was statistically significant in the same group（P〈0.05）. These indicators in treatment group improved better than those in the control group, with significant differences between two groups（P〈0.05）. Conclusion Alprostadil has good clinical efficacy in treatment of transient ischemic attack with no obvious adverse reaction, and has the advantages of high efficiency and safety, which is worthy of clinical popularization and application.