神经节苷酯联合依达拉奉注射液治疗急性脑梗死临床研究

CLINICAL STUDY OF GANGLIOSIDE COMBINED WITH EDARAVONE INJECTION IN THE TREATMENT OF ACUTE CEREBRAL INFARCTION

目的:探讨神经节苷酯联合依达拉奉注射液治疗急性脑梗死临床效果。方法:选取我院2014-04～2016-03间就诊的急性脑梗死病人212例,按照随机分组原则分对照组(100例)和观察组(112例),所有病人均予以常规阿司匹林肠溶片100 mg/次,1次/d,同时积极纠正血糖、血压,对照组在此基础上加用依达拉奉注射液(30mL加入0.9%氯化钠注射液250mL,静脉滴注);观察组在对照组基础上联合神经节甘酯(将100 mg神经节苷酯混入0.9%氯化钠250mL中,1次/d,连续静脉滴注10 d)。观察两组NIHSS评分、ADL评分、CBF及临床疗效。结果:治疗前,组间NIHSS评分、ADL评分、CBF均未见统计学差异(P>0.05);治疗后1wk两组NIHSS评分均显著下降,且观察组5.81±1.36明显低于对照组7.36±1.98,组间比较差异显著(P<0.05),治疗1mo后组间NIHSS评分比较无统计学差异(P>0.05);治疗1mo后,两组病人ADL评分均显著升高,治疗后3mo,ADL评分趋于稳定,治疗后1mo、3mo及6mo观察组ADL评分84.02±5.36、90.15±8.15、91.45±5.32均高于对照组76.02±6.02、81.45±11.35、81.65±9.45,组间比较差异显著(P <0.05);治疗后观察组CBF(mL/100 g·min)明显高于对照组33.02±6.12 vs 27.65±5.91,组间差异显著(P<0.05)。观察组临床总有效率为96.43%,高于对照组的76.00%,组间比较差异显著(P<0.05)。结论:神经节苷酯联合依达拉奉注射液治疗急性脑梗死可有效改善脑血流量,缓解脑缺血,提高近期神经功能及日常生活能力,疗效确切。

Objective： To investigate the clinical effect of ganglioside combined with edaravone injection in the treatment of acute cerebral infarction. Methods： 212 cases of patients with acute cerebral infarction in our hospital from April 2014 to March 2016 were selected, patients were randomly divided into the control group （100 cases） and the observation group （112 cases）,all patients were given conventional Aspirin enteriC-coated tablets 100 mg/time, 1 time/day, blood glucose, blood pressure were actively corrected, the control group received edaravone injection （30 ml joins 250 ml 0.9 % sodium chloride injection , intravenous drip）;The observation group received butylphthalide on the basis of the treatment of the control group （ 0.2 g/time, 3 times/day）. The NIHSS score, ADL score, CBF and clinical curative effect were observed. Results： Before treatment, NIHSS score, ADL score, CBF between the groups showed no significant difference （ P 〉 0.05 ）; At 1 week after treatment, the NIHSS score of the two groups were significantly decreased, and data of the observation group 5.81 ± 1.36 was significantly lower than that of the control group 7.36 ± 1.98 , a significant difference between the two groups was shown（ P 〈 0.05 ）.No statistic difference after 1month of treatment between groups in NIHSS score （ P 〉 0.05 ）; At 1month after treatment, the ADL score of the two groups were significantly increased, ADL score at 3months after treatment tended to be stable,at 1month, 3months and 6months after treatment, ADL score of the observation group 84.02 ± 5.36 , 90.15 ± 8.15 , 91.45 ± 5.32 were higher than those of the control group 76.02 ± 6.02 , 81.45 ± 11.35 , 81.65 ± 9.45 , a significant difference between the two groups was shown P 〈 0.05 ;The CBF of the observation group after treatment （unit：ml/100 g·min） was significantly higher than that of the control group 33.02 ± 6.12 vs 27.65 ± 5.91 , there was a significant difference between groups （ P 〈 0.05 ）.The total clinical efficiency rate of the observation group was 96.43 %, which was higher than that of the control group 76%, there was a significant difference between the two groups （ P 〈 0.05 ）. Conclusion： Ganglioside combined with combined with edaravone injection in the treatment of acute cerebral infarction can effectively improve cerebral blood flow , alleviate cerebral ischemia, enhance recent neurological function and ability of daily life, and shows exact effect.