养心定悸胶囊联合阿替普酶治疗心源性脑梗死疗效观察

Clinical Observation on Yangxin Dingji Capsules Combined with Alteplase in the Treatment of Cardiogenic Cerebral Infarction

目的探讨养心定悸胶囊联合阿替普酶静脉溶栓治疗心源性脑梗死(CCE)的临床疗效。方法选取医院2014年3月至2016年12月收治的CCE患者101例,随机分为对照组(48例)和观察组(53例)。对照组患者给予阿替普酶静脉滴注,首剂量10%在最初1 min内静脉推注,其余剂量持续静脉滴注1 h;观察组患者在此基础上加用养心定悸胶囊(每次4 g,每日2次)。结果观察组总有效率为90. 57%,显著高于对照组的81. 25%(P <0. 05);治疗后12 h,两组患者美国国立卫生研究院卒中量表(NIHSS)评分均降低(P <0. 05),且观察组在治疗7,20,60 d后低于同时点对照组(P <0. 05);两组患者治疗60 d后改良Rankin(m RS)评分均较治疗20 d后降低(P <0. 05),且观察组均低于对照组(P <0. 05);治疗后,两组患者血清D-二聚体、N末端B型脑利钠肽原(NT-proBNP)水平均较治疗前降低(P <0. 05),且观察组低于对照组(P <0. 05);治疗后,两组胸闷、心悸、气短证候评分均较治疗前降低(P <0. 05),且观察组低于对照组(P <0. 05);两组治疗过程均未见明显不良反应。结论养心定悸胶囊联合阿替普酶静脉溶栓能显著改善CCE患者神经功能缺损程度,减少血栓形成,改善临床证候,安全有效。

Objective To investigate the clinical effect of Yangxin Dinji Capsules combined with intravenous thrombolysis with alteplase in the treatment of cardiogenic cerebral embolism(CCE).Methods Totally 101 patients with CCE admitted to our hospital from March 2014 to December 2016 were selected and randomly divided into the control group(48 cases)and the observation group(53 cases).The patients in the control group were given intravenous drip of alteplase,the first dose of 10%alteplase was intravenously injected within the first 1 min,and the remaining dose was continuously dripped within 1 h.On this basis,the patients in the observation group were given Yangxin Dingji Capsules(4 g each time,twice a day).Results After treatment,the total effective rate of the observation group was 90.57%,which was significantly higher than 81.25%of the control group(P<0.05).The National Institutes of Health Stroke Scale(NIHSS)scores of the two groups were decreased at 12 h after treatment(P<0.05),and the NIHSS scores of the observation group were lower than those of the control group on the 7th,20th and 60th day after treatment(P<0.05).The modified Rankin scores(mRS)of the two groups on the 60th day after treatment were lower than those on the 20th day after treatment(P<0.05),and that in the observation group was lower than that in the control group(P<0.05).After treatment,the levels of serum D-dimer and N-terminal B-type natriuretic peptide(NT-proBNP)in the two groups were lower than those before treatment(P<0.05),and those in the observation group were lower than those in the control group(P<0.05).After treatment,the scores of chest tightness,palpitation and shortness of breath syndrome in the two groups were lower than those before treatment(P<0.05),and those in the observation group were lower than those in the control group(P<0.05).There were no obvious adverse reactions during the treatment in the two groups.Conclusion Yangxin Dinji Capsules combined with intravenous thrombolysis of alteplase can significantly improve the degree of nerve function defect in patients with CCE,reduce thrombosis,improve the clinical symptoms.It is safe and effective.