促红细胞生成素治疗老年脑梗死疗效观察

Effect of erythropoietin in the treatment of elderly patients with cerebral infarction

目的探讨促红细胞生成素(EPO)治疗老年脑梗死患者的临床疗效及不良反应。方法选择2015年6月至2016年12月长垣县人民医院神经内科收治的180例老年脑梗死患者,分为治疗组和对照组,每组90例。对照组患者进行常规治疗,治疗组患者在常规治疗基础上应用EPO治疗。观察2组患者的临床治疗效果及不良反应,评估治疗前后患者脑梗死面积、神经功能缺损程度(AS)及日常生活状况,同时检测患者治疗前后血清C反应蛋白(CRP)水平。结果治疗组患者治疗总有效率(90.00%,81/90)显著高于对照组(77.78%,70/90)(χ~2=4.57,P<0.05)。对照组、治疗组患者治疗前脑梗死面积分别为(8.96±0.35)、(9.01±0.23)cm^2,治疗后分别为(5.47±0.12)、(4.03±0.48)cm^2,2组患者治疗前脑梗死面积比较差异无统计学意义(P>0.05),治疗后2组患者脑梗死面积均较治疗前显著缩小,且治疗组患者脑梗死面积显著低于对照组(P<0.05)。2组患者治疗前AS、巴氏指数(BI)评分及血清CRP水平比较差异均无统计学意义(P>0.05);2组患者治疗后AS评分及血清CRP水平均较治疗前显著降低,BI评分较治疗前显著增加,且治疗组患者治疗后AS评分及血清CRP水平较对照组下降更显著,BI评分较对照组增加更显著(P<0.05)。对照组患者不良反应发生率50.00%,病死率8.89%;治疗组患者不良反应发生率为41.11%,病死率为6.67%,2组患者不良反应发生率、病死率比较差异均无统计学意义(χ~2=1.43、0.31,P>0.05)。结论 EPO治疗老年脑梗死的临床效果显著,且神经功能可得到明显改善,具有较高的安全性。

Objective To explore the clinical efficacy and side effects of erythropoietin（ EPO） in the treatment of senile cerebral infarction. Methods One hundred and eighty patients with senile cerebral infarction in the Department of Neurology,the People＇s Hospital of Changyuan County from June 2015 to December 2016 were selected and divided into treatment group and control group,with 90 patients in each group. All patients were given conventional therapy; based on this,the patients in treatment group were given EPO. The clinical efficacy and side effects of patients in the two groups was observed. The area of cerebral infarction,neurological deficits（ AS） and daily living status of patients were assessed and the concentration of serum C-reactive protein（ CRP） was measured before and after treatment. Results The total effective rate of patients in treatment group（ 90. 00%,81/90） was significantly higher than that in the control group（ 77. 78%,70/90）（ χ^2= 4. 57,P〈0. 05）.Before treatment,the area of cerebral infarction in control group and treatment group was（ 8. 96 ± 0. 35）,（ 9. 01 ± 0. 23） cm^2 respectively; after treatment,the area of cerebral infarction in control group and treatment group was（ 5. 47 ± 0. 12）,（ 4. 03 ±0. 48） cm^2 respectively. There was no statistic difference in the area of cerebral infarction between the two groups before treatment（ P〈0. 05）. The areas of cerebral infarction in the two groups after treatment were significantly smaller than those before treatment（ P〈0. 05）; and the area of cerebral infarction in the treatment group after treatment was significantly smaller than that in the control group（ P〈0. 05）. There was no significant difference in assessment standard（ AS）,Barthel index（ BI）score and serum CRP level between the two groups before treatment（ P〉0. 05）. The AS score and serum CRP levels in the two groups after treatment were significantly lower than those before treatment（ P〈0. 05）; but the BI score was significantly higher than that before treatment（ P〈0. 05）. After treatment,the AS score and serum CRP levels of patients in the treatment group were significantly lower than those in the control group,but the BI score was significantly higher than that in the control group（ P〈0. 05）. The incidence of adverse reactions and mortality of patients in the control group was 50. 00%,8. 89% respectively; the incidence of adverse reactions and mortality of patients in the treatment group was 41. 11%,6. 67% respectively; there was no significant difference in the incidence of adverse reactions and mortality between the two group（ χ^2= 1. 43,0. 31; P〈0. 05）. Conclusion EPO for treatment of senile cerebral infarction has good clinical effect and high safety,and it can improve the neurological function distinctly.