依达拉奉联合尼莫地平治疗急性大面积脑梗死的疗效分析

Efficacy Analysis of Edaravone Combined with Nimodipine in the Treatment of Acute Large Area Cerebral Infarction

目的:探讨依达拉奉联合尼莫地平治疗急性大面积脑梗死患者的疗效和安全性。方法:回顾性分析101例急性大面积脑梗死患者资料,按用药的不同分为对照组(53例)和观察组(48例)。入院后,对照组患者均采用减轻脑水肿、抗凝、抗血小板凝聚等常规治疗;观察组患者在对照组治疗的基础上给予依达拉奉注射液30 mg,加入0.9%氯化钠注射液100 m L中,静脉滴注,30min内滴完,每日2次+尼莫地平注射液12 mg,加入0.9%氯化钠注射液500 m L中,静脉滴注,每日1次,滴速为0.5μg/(kg·min),连用10 d,后改用口服尼莫地平片60 mg,每日3次,连用5 d。两组疗程均为15 d。观察两组患者的临床疗效,治疗前后血氧饱和度(Sp O2)、血红蛋白(Hb)、血红蛋白总量(HBT)、还原血红蛋白(MHb)、神经功能缺损程度(NIHSS)评分及不良反应发生情况。结果:观察组患者总有效率显著高于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者SpO_2、Hb、HBT、MHb水平及NIHSS评分比较,差异均无统计学意义(P>0.05)。治疗后,两组患者Sp O2、HBT、MHb水平均显著高于同组治疗前,且观察组显著高于对照组;两组患者NIHSS评分均显著低于同组治疗前,且观察组显著低于对照组;两组患者Hb水平显著低于同组治疗前,差异均有统计学意义(P<0.05),但两组间Hb水平比较差异均无统计学意义(P>0.05)。两组患者治疗期间均未见明显不良反应发生。结论:在常规治疗的基础上,依达拉奉联合尼莫地平治疗急性大面积脑梗死的疗效显著,能改善患者神经功能缺损程度,且未增加不良反应的发生。

OBJECTIVE：To investigate therapeutic efficacy and safety of edaravone and nimodipine in the treatment of acute large area cerebral infarction. METHODS：101 patients with acute large area cerebral infarction were analyzed retrospectively and divided into control group （53 cases） and observation group （48 cases） according to drug use. After admission,control group re-ceived routine treatment as relieving cerebral edema,anticoagulant and antiplatelet agglutination. Observation group was additional-ly given Edaravone injection 30 mg added into 0.9%Sodium chloride injection 100 mL intravenously,within 30 min,twice a day＋Nimodipine injection 12 mg added into 0.9%Sodium chloride injection 500 mL intravenously,once a day,at dripping speed of 0.5μg/（kg·min）,for 10 days,and then given Nimodipine tablet 60 mg orally instead,3 times a day,for 5 d,on the basis of control group. Treatment course of 2 groups lasted for 15 d. Clinical efficacies of 2 groups were observed as well as SpO2,hemoglobin （Hb）,total hemoglobin （HBT）,reduced hemoglobin （MHb）,NIHSS score and the occurrence of ADR before and after treat-ment. RESULTS：Total response rate of observation group was significantly higher than that of control group,with statistical signifi-cance（P〈0.05）. Before treatment,there was no statistical significance in the levels of SpO2,Hb,HBT,MHb and NIHSS score between 2 groups （P〉0.05）. After treatment,the levels of SpO2,HBT and MHb in 2 groups were significantly higher than be-fore,and the observation group was significantly higher than the control group;NIHSS score of 2 groups were significantly lower than before,and the observation group was significantly lower than the control group;Hb level of 2 groups were significantly low-er than before,with statistical significance（P〈0.05）,but there was no statistical significance in Hb level between 2 groups（P〉0.05）. No obvious ADR was found in 2 groups during treatment. CONCLUSIONS：On the basis of conventional therapy,edara-vone combined with nimodipine in the treatment of acute large area cerebral infarction has significant therapeutic efficacy,can im-prove neurological impairment,but doesn＇t increase the occurrence of ADR.