丹参川芎嗪注射液联合阿替普酶治疗老年急性脑梗死的疗效观察

Clinical observation of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection combined with alteplase in treatment of acute cerebral infarction in elderly patients

目的研究丹参川芎嗪注射液联合注射用阿替普酶治疗老年急性脑梗死的临床疗效。方法选取西安市第九医院神经内科2015年8月—2017年8月接收的120例老年急性脑梗死患者作为研究对象,将所有患者随机分为对照组和治疗组,每组各60例。对照组给予注射用阿替普酶,0.9 mg/kg,总剂量的10%静脉推注,剩余剂量在随后60 min内持续静脉滴注。治疗组在对照组治疗的基础上静脉滴注丹参川芎嗪注射液,用5%葡萄糖注射液250m L进行稀释,5m L/次,1次/d。两组患者均持续治疗14 d。观察两组患者的临床疗效,同时比较治疗前后两组的神经功能缺损量表(NIHSS)评分和脑梗死灶体积。结果治疗后,对照组和治疗组的总有效率分别为80.00%、95.00%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者NIHSS评分均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后,治疗组NIHSS评分明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组脑梗死灶体积显著减小,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后,治疗组脑梗死灶体积显著小于对照组,两组比较差异具有统计学意义(P<0.05)结论丹参川芎嗪注射液联合注射用阿替普酶治疗老年急性脑梗死具有较好的临床疗效,可改善患者NIHSS评分,降低脑梗死灶体积,安全性较高,具有一定的临床推广应用价值。

Objective To study the clinical effect of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection combined with Alteplase for injection in treatment of acute cerebral infarction in elderly patients. Methods Elderly patients（120 cases） with acute cerebral infarction in Department of Neurology of the Ninth Hospital of Xi’an from August 2015 to August 2017 were randomly divided into control and treatment groups, and each group had 60 cases. Patients in the control group were given Alteplase for injection, 0.9 mg/kg, 10% of the total dose was intravenously injected, and the remaining dose was continuously intravenous drip within 60 min. Patients in the treatment group were iv administered with Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection on the basis of the control group, diluted with 5% glucose injection 250 mL, 5 mL/time, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and the NIHSS scores and the volumes of cerebral infarction area before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 80.00% and 95.00%, respectively, and there was difference between two groups（P 〈 0.05）. After treatment, the NIHSS score in two groups were significantly decreased, and there were differences in the same group（P 〈 0.05）. After treatment, the NIHSS score in the treatment group were significantly lower than those in the control group, and there were differences between two groups（P 〈 0.05）. After treatment, the volumes of cerebral infarction area in two groups were significantly decreased, and there were differences in the same group（P 〈 0.05）. After treatment, the volumes of cerebral infarction area in the treatment group were smaller than those in the control group, and there were difference between two groups（P 〈 0.05）. Conclusion Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection combined with Alteplase for injection has clinical curative effect in treatment of acute cerebral infarction in elderly patients, can improve the NIHSS score, and also can reduce the volumes of cerebral infarction area, with high safety, which has a certain clinical application value.