单唾液酸四己糖神经节苷脂联合高压氧治疗急性脑梗死的临床疗效

Clinical efficacy of monosiaotetrahexosyl ganglioside combined with hyperbaric oxygen in treatment of patients with acute cerebral infarction

目的 观察单唾液酸四己糖神经节苷脂（GM1）联合高压氧治疗急性脑梗死的临床疗效。方法将80例急性脑梗死患者随机分为常规治疗组（40例）和联合治疗组（40例）。两组均常规予以阿托伐他汀分散片、拜阿司匹林肠溶片、血栓通、巴曲酶治疗,并辅以控制血压、血糖等治疗。联合治疗组在常规治疗基础上予以GM1（生理盐水＋GM1 40 mg/d）联合高压氧治疗,疗程10 d。治疗前后分别采用NIHSS、日常生活活动量表（ADL）的Barthel指数评价患者的神经功能;治疗3个月后对患者进行mRS评分。结果 治疗前常规治疗组及联合治疗组患者NIHSS评分及Barthel指数差异无统计学意义（均P〉0.05）。与治疗前比较,常规治疗组及联合治疗组治疗后Barthel指数显著升高,NIHSS评分显著降低（均P〈0.01）。与常规治疗组比较,联合治疗组治疗后NIHSS评分及mRS评分显著降低,Barthel指数评分显著升高（均P〈0.05）。联合治疗组总有效率显著高于常规治疗组（χ~2=5.00,P=0.025）。两组患者均未发生明显的不良反应。结论 对于未能进行溶栓治疗的急性脑梗死患者,积极予以常规治疗可改善患者预后;在此基础上的进行GM1联合高压氧治疗更能有效促进急性脑梗死患者神经功能状态的康复和远期疗效,且安全有效,值得临床推广。

Objective To observed the clinical efficacy of monosiaotetrahexosyl ganglioside（ GM1） combined with hyperbaric oxygen in treatment of patients with acute cerebral infarction. Methods Eighty patients with acute cerebral infarction were randomly divide into conventional therapy group（ 40 cases） and combined treatment group（ 40 cases）. Two groups were given conventional treatment with atorvastatin,aspirin,xueshuantong,batroxobin,and control blood pressure and blood glucose. In addition,the combined treatment group were given GM1（ normal saline ＋ GM1 40 mg / d） combined with hyperbaric oxygen treatment for 10 d. NIHSS and Barthel index of activities of daily living scale（ ADL） were applied to assess the neurological functions of the patients. After 3 months of treament,mRS score was used to evaluat patients. Results Before treatment,there was no significant difference in NIHSS score and Barthel index between the conventional therapy group and the combined treatment group（ all P 0. 05）. Compared with before treatment,the Barthel index in conventional herapy group and the combined treatment group was significantly higher,and NIHSS score was significantly lower（ all P 0. 01）. Compared with conventional therapy group,the NIHSS score and mRS score in combined treatment group were significantly lower,and Barthel index score was significantly higher after treatment（ all P 0. 05）. The total effective rate in combined treatment group was significantly higher than that in conventional herapy group（ χ~2= 5. 00,P = 0. 025）. No obvious adverse reactions occurred in the two groups throughout the course of treatment. Conclusions Conventional therpy can improve the prognosis of patients with acute cerebral infarction who failed to carry out thrombolytic therapy. On this basis,GM1 combined with hyperbaric oxygen can effectively improve the rehabilitation of nervel function and the long-tern effects in patients with acute cerebral infarction,and are safe and effective,worthy of clinical promotion.