神经节苷脂联合羟乙基淀粉对急性脑梗死患者mRS评分和NIHSS评分的影响

Effect of ganglioside combined with hydroxyethyl starch on mRS score and NIHSS score in patients with acute cerebral infarction

目的研究神经节苷脂联合羟乙基淀粉对急性脑梗死患者改良Rankin量表(mRS)评分和美国国立卫生研究院卒中量表(NIHSS)评分的影响。方法300例急性脑梗死患者,随机分为对照组和观察组,各150例。对照组给予神经节苷脂治疗,观察组给予神经节苷脂联合羟乙基淀粉治疗。比较两组临床疗效、不良反应发生情况及治疗前后mRS评分、NIHSS评分、血液流变学指标。结果观察组治疗总有效率90.67%明显高于对照组的70.00%,差异有统计学意义(P<0.05)。治疗后第1、7、14天,两组NIHSS评分均低于治疗前,差异有统计学意义(P<0.05);观察组治疗后第1、7、14天NIHSS评分分别为(9.48±1.36)、(7.58±1.29)、(6.25±1.13)分,均明显低于对照组的(14.27±2.65)、(11.34±2.19)、(9.34±1.56)分,差异有统计学意义(P<0.05)。治疗后1、3个月,两组mRS评分均低于治疗前,差异有统计学意义(P<0.05);观察组治疗后1、3个月mRS评分分别为(2.63±0.31)、(2.31±0.25)分,均明显低于对照组的(3.22±0.25)、(3.14±0.23)分,差异有统计学意义(P<0.05)。治疗后,两组全血粘度、血小板聚集率和纤维蛋白原均低于治疗前,且观察组全血粘度明显低于对照组,差异有统计学意义(P<0.05),观察组与对照组血小板聚集率和纤维蛋白原对比,差异无统计学意义(P>0.05)。结论神经节苷脂联合羟乙基淀粉治疗急性脑梗死患者的疗效明显优于单用神经节苷脂,能明显改善mRS评分以及NIHSS评分。

Objective To study the effect of ganglioside combined with hydroxyethyl starch on modified Rankin scale(mRS)score and National Institutes of Health stroke scale(NIHSS)score in patients with acute cerebral infarction.Methods A total of 300 patients with acute cerebral infarction were randomly divided into the control group and the observation group,with 150 cases in each group.The control group was treated with ganglioside,and the observation group was treated with ganglioside in combination with hydroxyethyl starch.The clinical efficacy,occurrence of adverse reactions,mRS scores,NIHSS scores and hemorheology indexes before and after treatment were compared between the two groups.Results The total effective rate of treatment 90.67%in the observation group was significantly higher than 70.00%in the control group,and the difference was statistically significant(P<0.05).1,7,and 14 days after treatment,the NIHSS scores of the two groups were lower than those of this group before treatment,and the difference was statistically significant(P<0.05).The NIHSS scores of the observation group were(9.48±1.36),(7.58±1.29),(6.25±1.13)points 1,7,and 14 days after treatment,which were significantly lower than(14.27±2.65),(11.34±2.19),(9.34±1.56)points of the observation group,and the difference was statistically significant(P<0.05).1 and 3 months after treatment,the mRS scores of the two groups were lower than those of this group before treatment,and the difference was statistically significant(P<0.05).The mRS scores of the observation group were(2.63±0.31)and(2.31±0.25)points 1 and 3 months after treatment,which were significantly lower than(3.22±0.25)and(3.14±0.23)points of the control group,and the difference was statistically significant(P<0.05).After treatment,the whole blood viscosity,platelet aggregation rate and fibrinogen of the two groups were lower than those of this group before treatment,and the whole blood viscosity of the observation group was significantly lower than that of the control group.All the differences were statistically significant(P<0.05).There was no statistically significant difference in platelet aggregation rate and fibrinogen between the observation group and the control group(P>0.05).Conclusion Ganglioside in combination with hydroxyethyl starch has obviously better efficacy than ganglioside for patients with acute cerebral infarction,and it can obviously improve the mRS score and NIHSS score of patients.