丹参酮Ⅱ_A磺酸钠联合吲哚布芬对心源性脑栓塞血液流变学的影响

Effect of sodium tanshinone Ⅱ_A sulfonate combined with indobufen on blood rheology of cardiac cerebral embolism

目的观察丹参酮Ⅱ_A磺酸钠联合吲哚布芬治疗心源性脑栓塞的临床疗效,探讨该联合治疗方案对血液流变学改变的作用机制,为临床治疗心源性脑栓塞提供理论依据。方法按入院先后顺序将我院康复中心2014年1月至2015年4月收治的224例脑栓塞住院患者,随机分为对照组与观察组。对照组对症治疗(如脱水及口服吲哚布芬+舒降之),观察组在此基础上静脉滴注丹参酮Ⅱ_A磺酸钠注射液,检测治疗前及治疗21 d后血液流变学指标,记录脑电图(Electroencephalogram,EEG)病理性棘波振幅及局部脑血流量(Regional cerebral blood flow,rCBF),计算治疗前、后患者卒中量表神经缺损(ESS)评分、日常生活能力(ADL)评分及总有效率,比较两组临床疗效。结果丹参酮Ⅱ_A磺酸钠联合吲哚布芬能显著降低脑栓塞患者脑电图病理性棘波振幅、ESS评分及血液流变学指标,显著提高脑栓塞患者局部脑血流量、ADL评分及总有效率,与对照组比较,差异均有统计学意义(P<0.05)。结论丹参酮Ⅱ_A磺酸钠联合吲哚布芬能明显改善患者血液流变学效应,松弛脑栓塞区血管平滑肌以增加局部脑血流量,降低脑栓塞患者脑电图病理性棘波振幅,有效改善脑栓塞患者神经功能缺损及临床症状,提高患者日常生活能力,对脑栓塞有理想的治疗作用,有一定的临床推广价值。

Objective To,observe the clinical curative effect of tanshinone ⅡA sulfonate combined with indobufen on cardiac cerebral embolism and to explore the effect of the combined therapy on the changes of blood Theology,so as to provide a theoretical basis for the clinical treatment of cardiogenic cerebral.Methods 224 patients with cerebral embolism in our hospital from January 2014 to April 2015 were randomly divided into control group and observation group.Control group received symptomatic treatment,such as dehydration and oral indobufen ＋ shu drop pbservation group received intravenous drip of tanshinone ⅡA sulfonate sodium injection on the basis of control group,the blood rheological index was measured before and after 21 d of treatment.The electroencephalogram（EEG） pathological spike wave amplitude and regional cerebral blood flow（rCBF） were recorded,and stroke volume table nerve defect score（ESS）,ability of daily life（ADL） score and total efficiency were calculated before and after treatment The clinical curative effect of the two groups was compared.Results Tanshinone ⅡA sulfonate sodium combined with indobufen can significantly reduce cerebral embolism patients＇ EEG pathology spike and wave amplitude,ESS score and blood rheology index,significantly improve the blood flow of brain embolism,ADL scores and the total effective rate,there were significant differences between treatment group and control group（P〈0.05）.Conclusion Tanshinone ⅡA sulfonate sodium combined with indobufen can significantly improve the patient＇ s blood rheology effect,relax the cerebral embolism vascular smooth muscle,and increase regional cerebral blood flow,reduce patients＇ EEG pathology spike wave amplitude and effectively improve neurologic impairment and clinical symptoms,improve the ability of daily life,with ideal therapeutic effect on cerebral embolism,it has certain clinical value.