羟乙基淀粉扩容治疗大脑中动脉狭窄致内分水岭脑梗死效果观察

Observation of effect by hydroxyethyl starch volume expansion therapy for cerebral watershed infarction caused by middle cerebral artery stenosis

目的观察分析羟乙基淀粉扩容治疗大脑中动脉狭窄致内分水岭脑梗死的临床疗效。方法 72例大脑中动脉狭窄所致内分水岭脑梗死患者,随机分为对照组与观察组,每组36例。对照组患者进行常规抗血小板与降脂治疗,观察组在对照组基础上给予羟乙基淀粉扩容治疗。对两组患者病变侧大脑中动脉血流速度进行经颅多普勒(TCD)检测以及美国国立卫生研究院卒中量表(NIHSS)评分。结果两组患者治疗后收缩期最大峰值流速(Vs)、舒张末期血流速度(Vd)与平均血流速度(Vm)水平均显著高于治疗前(P<0.05),且观察组显著高于对照组(P<0.05)。两组患者治疗后7、14 d的NIHSS评分均较治疗前显著降低(P<0.05);且观察组患者治疗后7 d的NIHSS评分为(6.8±2.1)分,治疗后14 d为(4.2±1.8)分,显著低于对照组的(7.6±2.3)、(6.3±2.1)分,差异具有统计学意义(P<0.05)。结论对因大脑中动脉狭窄所致的内分水岭脑梗死,采用羟乙基淀粉予以扩容治疗效果更优。

Objective To observe and analyze clinical effect by hydroxyethyl starch volume expansion therapy for cerebral watershed infarction caused by middle cerebral artery stenosis. Methods A total of 72 patients with cerebral watershed infarction caused by middle cerebral artery stenosis were randomly divided into control group and observation group, with 36 cases in each group. The control group received conventional antiplatelet and lipid-lowering therapy, and the observation group received additional hydroxyethyl starch volume expansion therapy to treatment in the control group. Transcranial Doppler （TCD） detection and National Institutes of Health Stroke scale （NIHSS） were made on affected middle cerebral artery flow velocity in the two groups. Results Both groups had obviously higher maximal systolic peak velocity （Vs）, end diastolic velocity （Vd） and mean flow velocity （Vm） after treatment than those before treatment （P〈0.05）, and the observation group had all higher indexes than the control group （P〈0.05）. Both groups had obviously lower NIHSS scores in 7, 14 d after treatment than those before treatment （P〈0.05）. The observation group had NIHSS score as （6.8 - 2.1） points in 7 d after treatment and （4.2 ± 1.8） points in 14 d after treatment, which were much lower than （7.6 ± 2.3） and （6.3 ± 2.1） points in the control group, and their difference had statistical significance （P〈0.05）. Conclusion Implement of hydroxyethyl starch volume expansion therapy shows excellent curative effect for cerebral watershed infarction caused by middle cerebral artery stenosis.