前列地尔对腔隙性脑梗死老年患者微循环和血液流变学的影响

Influence of Alprostadil on Microcirculation and Hemorheology of Elderly Patients with Lacunar Infarction

目的探讨前列地尔对腔隙性脑梗死老年患者微循环和血液流变学的影响。方法选择医院收治的腔隙性脑梗死老年患者120例,随机分为对照组和观察组,各60例。两组患者均给予降压、调脂、降糖等基础治疗,并给予肌氨肽苷、阿司匹林、阿托伐他汀、尼莫地平改善微循环、抗血栓形成等常规治疗,观察组患者在此基础上静脉滴注前列地尔,7 d为1个疗程,共治疗2个疗程。结果治疗后,两组患者的神经功能缺损程度评分、认知功能缺损综合评分、血液流变学各项指标、甲襞微循环各项指标积分均得到显著改善,且观察组改善幅度更明显(P<0.05);两组不良反应均较轻,组间比较差异无统计学意义(P>0.05)。结论加用前列地尔治疗腔隙性脑梗死,可对老年患者血液流变学和微循环产生积极影响,改善神经功能和认知功能,且不良反应较少,安全性好,值得临床推广。

Objective To investigate the influence of alprostadil on microcirculation and hemorheology of the elderly patients with lacu-nar infarction. Methods Totally 120 patients with lacunar infarction were randomly divided into the control group and the observation group,60 cases in each group. The two groups were given the treatment of depressurization,lipid regulation and reducing blood glucose, and the conventional treatment with muscular amino acids and nucleosides,aspirin,atorvastatin,nimodipine to inrprove microcirculation and anti-thrombosis. On this basis,the observation group was given alprostadil by intravenous infusion. The course of treatment was 7 d, and the two groups were treated for 2 courses. Results After treatment,the degree of neurological deficit scores,cognitive impairment composite scores,hemorheological indexes,nail fold microcirculation index scores in the two groups were significantly improved than before treatment,and the observation group improved more obviously（ P ﹤ 0. 05）. The occurrence rate of the adverse reactions had no significant difference between the two groups（ P ﹥ 0. 05）. Conclusion The addition of alprostadil in treating lacunar infarction has positive influence on blood hemorheology and microcirculation with less adverse reactions,and is worthy of clinical promotion.