依达拉奉联合低分子肝素治疗进展性脑梗死的临床疗效及其对凝血功能的影响研究

Clinical Effect of Edaravone Combined with Low Molecular Weight Heparin on Progressive Cerebral Infarction and the Impact on Coagulation Function

目的探讨依达拉奉联合低分子肝素(LMWH)治疗进展性脑梗死(PCI)的临床疗效及其对凝血功能的影响。方法选取2014—2015年如皋市人民医院收治的PCI患者80例,随机分为A组与B组,每组40例。两组患者均予以常规治疗,A组患者予以依达拉奉联合LMWH治疗,B组患者予以LMWH治疗;两组患者均连续治疗15d。比较两组患者临床疗效,治疗前及治疗7 d凝血功能指标〔纤维蛋白原(FIB)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、国际标准化比值(INR)〕,治疗前及治疗7、15 d美国国立卫生研究院卒中量表(NIHSS)评分,随访3个月时Barthel指数(BI)及治疗期间不良反应发生情况。结果 A组患者临床疗效优于B组(P<0.05)。治疗前、治疗7 d两组患者FIB、TT、APTT、PT、INR比较,差异无统计学意义(P>0.05)。治疗前两组患者NIHSS评分比较,差异无统计学意义(P>0.05);治疗7、15 d A组患者NIHSS评分低于对照组(P<0.05)。随访3个月时A组患者BI评分高于B组(P<0.05)。两组患者治疗期间均未发生严重不良反应。结论依达拉奉联合LMWH治疗PCI的临床疗效确切,对凝血功能影响小,可有效改善患者神经功能并提高患者日常生活能力,且安全性较高。

Objective To investigate the clinical effect of edaravone combined with low molecular weight heparin on progressive cerebral infarction and the impact on coagulation function. Methods A total of 80 patients with progressive cerebral infarction were selected in the People′s Hospital of Rugao from 2014 to 2015,and they were randomly divided into A group and B group,each of 40 cases. Based on conventional treatment,patients of A group were given edaravone combined with low molecular weight heparin,while patients of B group were given low molecular weight heparin only;both groups continuously treated for 15 days. Clinical effect,index of coagulation function(including FIB,TT,APTT,PT and INR)before treatment and after 7 days of treatment,NIHSS score before treatment,after 7 and 15 days of treatment,BI score at the third month of follow - up,and incidence of adverse reactions during the treatment were compared between the two groups. Results Clinical effect of A group was statistically significantly better than that of B group(P < 0. 05). No statistically significant differences of FIB,TT,APTT,PT or INR was found between the two groups before treatment or after 7 days of treatment(P > 0. 05). No statistically significant differences of NIHSS score was found between the two groups before treatment(P > 0. 05),while NIHSS score of A group was statistically significantly lower than that of B group after 7 days,15 days of treatment,respectively(P <0. 05). BI score of A group was statistically significantly higher than that of B group at the third month of follow - up( P <0. 05). No one of the two groups occurred any severe adverse reactions during the treatment. Conclusion Edaravone combined&nbsp;with low molecular weight heparin has certain clinical effect in treating progressive cerebral infarction without obvious impact on the coagulation function,can effectively improve the patients′ neurological function and activity of daily living,and is relatively safe.