依达拉奉右崁醇联合阿加曲班对后循环急性脑梗死患者神经功能、血液流变学和后循环血流动力学的影响

Effects of edaravone dexborneol combined with argatroban on neurological function,hemorheology and hemodynamics of patients with acute cerebral infarction of posterior circulation

目的探讨依达拉奉右崁醇联合阿加曲班对后循环急性脑梗死患者神经功能、血液流变学和后循环血流动力学的影响。方法收集156例后循环急性脑梗死患者,随机分为常规治疗组、依达拉奉右崁醇治疗组(EDD治疗组)和依达拉奉右崁醇联合阿加曲班治疗组(联合治疗组),每组52例。收集三组患者一般资料,评估三组治疗前后NIHSS评分和Barthel指数、血液流变学和后循环血流动力学变化。结果治疗后三组患者的NIHSS评分和Barthel指数均较治疗前明显降低(均P<0.01)。联合治疗组治疗后NIHSS评分和Barthel指数低于EDD治疗组和常规治疗组(均P<0.05)。三组间总有效率差异有统计学意义(P<0.05),且联合治疗组优于EDD治疗组和常规治疗组(均P<0.05)。治疗后三组患者的血小板聚集率、红细胞压积、全血比黏度和血浆比黏度均较治疗前明显降低(均P<0.01)。治疗后联合治疗组血小板聚集率、红细胞压积、全血比黏度和血浆比黏度均明显低于EDD治疗组和常规治疗组(均P<0.05)。治疗后三组患者的基底动脉、椎动脉和大脑后动脉的收缩期峰血流速度(Vs)较治疗前均明显增高(均P<0.01),阻力指数(RI)较治疗前均明显降低(均P<0.01)。联合治疗组治疗后基底动脉、椎动脉和大脑后动脉的Vs均明显高于常规治疗组和EDD治疗组(均P<0.05),RI均明显低于EDD治疗组和常规治疗组(均P<0.05)。三组间不良反应比较差异均无统计学意义(均P>0.05)。结论依达拉奉右崁醇联合阿加曲班可以通过改善血液流变学和后循环血流动力学对后循环急性脑梗死患者神经功能发挥良好的保护作用。

Objective To investigate the effects of edaravone dextran combined with argatroban on neurological function,blood rheology and posterior circulation hemodynamics in patients with acute cerebral infarction in the posterior circulation.Methods One hundred and fifty-six patients with acute cerebral infarction in the posterior circulation were collected and randomly divided into the conventional treatment group,edaravone dextranol treatment group(EDD treatment group)and edaravone dextranol combined with argatroban treatment group(combined treatment group),with 52 cases in each group.The general data of patients in the three groups were collected,and the changes of NIHSS score and Barthel index,blood rheology and posterior circulation hemodynamics were evaluated before and after treatment in the three groups.Results After treatment,NIHSS scores and Barthel index were significantly lower in all three groups than before treatment(all P<0.01).The NIHSS score and Barthel index of the combined treatment group were significantly lower than those of the EDD treatment group and the conventional treatment group after treatment(all P<0.05).The difference in total effective rate among the three groups was statistically significant(P<0.05),and the total effective rate among in combined treatment group was significantly better than those in the EDD treatment group and the conventional treatment group(all P<0.05).The platelet aggregation rate,erythrocyte pressure volume,whole blood specific viscosity and plasma specific viscosity in the three groups after treatment were significantly lower than those before treatment(all P<0.01).After treatment,the platelet aggregation rate,erythrocyte pressure volume,whole blood specific viscosity and plasma specific viscosity of combined treatment group were lower than those of EDD treatment group and conventional treatment group(all P<0.05).Peak systolic blood flow velocity(Vs)of basilar artery,vertebral artery and posterior cerebral artery in the three groups after treatment were significantly higher than those before treatment(all P<0.01),and resistance index(RI)was significantly lower than that before treatment(all P<0.01).The Vs of basilar,vertebral and posterior cerebral arteries in the combined treatment group were significantly higher than those in the conventional treatment group and the EDD treatment group(all P<0.05),and the RI was significantly lower than that in the EDD treatment group and the conventional treatment group(all P<0.05).There was no significant difference in the comparison of adverse reactions among the three groups(all P>0.05).Conclusion Edaravone dextranol combined with argatroban can exert a good protective effect on neurological function in patients with acute cerebral infarction in the posterior circulation by improving blood rheology and posterior circulation hemodynamics.