大豆磷脂对脑梗塞治疗作用研究

Functional Study on Acute Cerebral Infarction with Soybean Lecithin

目的 :进一步探讨大豆磷脂对脑梗塞的治疗作用。方法 :发病 48h内 ,神经功能缺损积分在 2 0～ 30分的脑梗塞患者 42 1例分成 3组 :基础组 6 0例 ,脑梗塞常规治疗 ;胞二磷胆碱组 12 0例 ,基础组药物加胞二磷胆碱再加ATP治疗 ;大豆磷脂组 2 41例 ,基础组药物加大豆磷脂 10 g治疗。分组后立即治疗 ,发病后开始用药时间不同 ,但都在 48h之内。疗程 2 8天。结果 :疗程结束时 ,基础组、胞二磷胆碱组、大豆磷脂组的脑梗塞体积分别为 (7 0±2 8)cm3 、(6 4± 3 2 )cm3 、(5 2± 2 8)cm3 ,3组相比F =6 917,P <0 0 0 1,基础组、胞二磷胆碱组与大豆磷脂相比 ,Dunnett检验 ,t值分别为 4 4 15和 3 70 6 ,均P <0 0 1;神经功能缺损积分减少分别为 (11 2 6± 9 80 )分、(12 35±9 17)分和 (15 0 4± 10 32 )分 ,药物和发病后开始用药时间对疗程后神经缺损积分作用的 2因素析因设计资料方差分析 ,F药物 =5 843,P <0 0 1,F时间 =1 2 30 ,P >0 0 5 ,药物与时间的主成分分析 ,药物的贡献率为 0 5 2 73,时间的贡献率为 0 4 72 7;以死亡、恶化、无效、进步、显著进步、基本痊愈为序 ,3组综合疗效结果Ridit分析 :Ridit值分别为 0 4 397、0 4 436和 0 5 430 ,χ2 =12 5 5 ,P <0 0 1。结论

Objective:To further investigate the clinical curative effect on cerebral infarction with soybean lecithin.Methods:421 patients with cerebral infarction within 48h after the onset,whose nerve function defect integrals were 20～30,were divided into 3 groups.Basic group,60 patients,were cured with conventional treatment;citicoline group,120 patients,with conventional treatment with citicoline and ATP;soybean lecithin group,241 patients,with conventional treatment with soybean lecithin 10g tid.po..Beginning times of treatment in patients were different,but the times were all within 48 hours.The treatment course was 28 days.Results:When the course was over,in basic group,citicoline group and soybean lecithin group,the infarct volumes were 7.0cm\+3±2.8cm\+3,6.4cm\+3±3.2cm\+3 and 5.2cm\+3±2.8cm\+3 respectively,3 groups were compared F=6.917,P<0.001,basic group,citicoline group were compared with soybean group Dunnett test t=4.415 and 3.706,P<0.01,respectively;the decrease degree of nerve function defect integral were 11.26±9.80?12.35±9.17 and 15.04±10.32,respectively,two-way analysis of variance of drug and beginning time of treatment was carried out on the nerve function defect integral examined after the course,value of F in durgs was 5.483,P<0.01,value of F in times was 1.23,P>0.05;the principal component analysis of durg and time,the contribution of durg was 0.5273,time was 0.4727;in the order of death,deterioration,nonimprovement,improvement,significant improvement,recovery,Ridit anlysis of results of therapy in 3 groups,values of Ridit were 0.4397,0.4436 and 0.5430 respectively;χ 2=12.55,P<0.01.Conclusion:Soybean lecithin in the treatment of acute cerebral infarction has a better clinical curative effect;it is suggested that soybean lecithin may protect cell of brain from decrease of brain phospholipid content in brain ischemia.