脑心通胶囊在急性脑梗死尿激酶溶栓后的作用分析

目的探讨脑心通胶囊在急性脑梗死尿激酶溶栓过程后在脑缺血灶-再灌注损伤减轻,减少脑梗死体积及细胞凋亡方面的作用。方法采用符合静脉尿激酶溶栓的入院患者随机分为脑心通胶囊治疗组(54例)和丹参片对照组(48例),疗程3周,观察治疗前后多项评价指标的变化。结果脑心通胶囊治疗组在急性脑梗死溶栓后改善患者的生活能力及减轻神经功能的缺损等指标明显优于丹参片组(P<0.05)。结论脑梗死在溶栓后存在着脑缺血灶再灌注损伤是目前广泛关注的问题,脑心通胶囊在治疗急性脑梗死促进脑细胞功能的恢复具有良好的作用。

急性心肌梗死合并脑梗死的临床特点及治疗体会

目的总结急性心肌梗死合并脑梗死的临床特点及治疗体会。方法回顾性分析分院及本部2014年1月~2016年12月收治的12例急性心肌梗死合并脑梗死患者的临床资料,观察患者的临床特点及治疗效果。结果12例患者均为中老年患者,患者并发脑梗死的发生时间均为心肌梗死发生后1周内,全部给予低分子肝素,氯吡格雷,阿司匹林联合抗栓治疗。在发生脑梗死后8 h内给予尿激酶20万~40万U治疗,均未出现出血等并发症。结论心肌梗死患者应加强对患者疼痛、紧张的处理,控制严重心律失常,减少血压波动,严密观察神经系统症状和体征,对及时防范和治疗脑梗死有重要意义。

急性脑梗死患者S-100、MBP的检测及其临床关系的相关性研究

目的 动态观察急性脑梗死患者(acutecerebralinfarction,ACI)血浆中S 100蛋白(s 100pro tein,S 100)、髓鞘碱性蛋白(myelinbasicprotein,MBP)的变化,探讨其与脑梗死体积、神经功能缺损程度及梗死部位等方面的相关性。方法 该实验采用酶联免疫吸附法(eyzyme linkedimmunosorbentassay,ELISA)对50例ACI患者的血浆S 100、MBP水平进行动态检测,并与30例对照组患者进行比较,同时应用NIHSS进行神经功能缺损评分及CT扫描测定梗死体积。结果 ACI患者S 100、MBP浓度在发病早期明显升高,S 1001～3d达到峰值,MBP5～7d达到峰值,有严重神经功能缺损的患者S 100、MBP升高更明显,S 100>1.0μg/L、MBP>8.0μg/L、NIHSS>12分,均提示患者预后不良;S 100、MBP的血浆浓度与梗死体积呈显著正相关(r≥0.480,P<0.01),与神经功能缺损程度也呈显著正相关(r≥0.443,P<0.01)。结论 缺血性脑损伤后血浆中S 100、MBP的出现分别与神经胶质细胞、髓鞘受损有关,并通过受损的血脑屏障进入血液,S 100、MBP可作为缺血性脑损伤尤其是大面积脑梗死早期的外周标志物,是比CT更为敏感的指标,对指导治疗有帮助。

较大剂量舒降之长期治疗心脑血管病人颈动脉粥样斑块的疗效观察

目的:利用高频超声观察较大剂量舒降之治疗心肌梗死及脑梗死病人颈动脉粥样硬化斑块的疗效,评价长期服用较大剂量舒降之对斑块稳定性的作用。方法:选取211例有不同程度颈动脉粥样硬化斑块的心肌梗死及脑梗死病人,随机分为治疗和对照组。高频超声检测颈动脉内中膜及斑块的厚度,斑块类型的变化。结果:(1)治疗18mo后,颈动脉内膜中层厚度及斑块厚度无明显变化(P>0.05);36mo后颈动脉内膜中层及斑块厚度较治疗前及18mo时厚度明显变薄(P<0.01),而对照组较治疗前增厚(P<0.01)。(2)治疗组18mo后,治疗组的硬斑构成比比对照组的高,而软斑正好相反(P<0.01);治疗36mo后,治疗组的硬斑构成比和扁平斑构成比比对照组的高,而软斑和混合斑的正好相反(P<0.01)。结论:较大剂量舒降之具有稳定斑块,抑制颈动脉粥样硬化斑块进展的作用。随着治疗时间的延长,抗动脉硬化及稳定斑块的作用更加明显。

舒降之对心脑血管患者颈动脉粥样斑块稳定性影响的研究

目的利用超声观察舒降之治疗心肌梗死及脑梗死患者颈动脉粥样硬化斑块的疗效,评价舒降之对斑块稳定性的作用。方法选取211例有不同程度颈动脉粥样硬化斑块的心肌梗死及脑梗死患者,随机分为治疗组和对照组。所有患者服药前、服药18个月后均利用高频超声检查颈动脉斑块的厚度,斑块类型的变化。结果治疗18个月后,颈动脉斑块厚度无明显变化(P>0.05);而对照组增厚,但无统计学意义(P>0.05)。2治疗组18个月后,治疗组的硬斑构成比比对照组的高,而软斑正好相反(P<0.01)。结论舒降之可使颈动脉粥样硬化不稳定斑块转变为稳定斑块,但颈动脉斑块的厚度无明显变化。随着治疗时间的延长,舒降之控制斑块的厚度,稳定斑块的疗效是否会更加明显,有待进一步研究。

Electro-Acupuncture for Treatment of Dysequillibrium Due to Cerebellum or Brain Stem Infarction

The authors treated 26 cases of dysequillibrium due tocerebellum or brain stem infarction byelectro-acupuncture from Aug 2000 - April 2002. Theresults were quite satisfactory and reported as follows.

Effects of electroacupuncture pretreatment on motor function and cerebral blood flow in MCAO model rats

Objective:To observe the effects of electroacupuncture(EA)pretreatment on motor function,cerebral blood flow,cerebral infarction volume,and vascular endothelial growth factor(VEGF)level in middle cerebral artery occlusion(MCAO)model rats.Methods:Twenty-four male Sprague-Dawley rats were randomly divided into a normal group,a model group,and an EA group,with eight rats in each group.The middle cerebral artery ischemia-reperfusion model was established by the suture-occluded method in the model group and the EA group,while not in the normal group.The EA group was pretreated with EA at bilateral Fengchi(GB20)before model preparation,once a day for 30 min each time for a total of 7 d.The changes in the CatWalk gait parameters,modified Bederson neurological deficit score,cerebral blood flow,cerebral infarction volume after ischemia,and VEGF level in the brain tissue of rats in each group were observed.Results:Compared with the normal group,the modified Bederson neurological deficit score in the model group and the EA group increased after modeling(P<0.05),and the CatWalk gait parameters(one-leg stance duration,gait cadence,and gait cycle)were all changed(P<0.05).Compared with the model group,the modified Bederson neurological deficit score in the EA group decreased(P<0.05),and the CatWalk gait parameters improved(P<0.05).Immediately after ischemia,the cerebral blood flow in the normal group was greater than that in the model group and the EA group(P<0.05);after reperfusion,the cerebral blood flow in the EA group was greater than that in the model group(P<0.05).Compared with the normal group,the cerebral infarction volume in the model group and the EA group increased(P<0.05).Compared with the model group,the cerebral infarction volume in the EA group decreased(P<0.05).The expression level of VEGF-positive cells in the rat brain tissue in the model group was higher than that in the normal group(P<0.05),and was higher in the EA group than in the model group(P<0.05).Conclusion:EA pretreatment improves the limb motor function in MCAO model rats,alleviates the symptoms of neurological deficits,promotes the recovery of cerebral blood flow,reduces the cerebral infarction area after MCAO modeling,and increases the VEGF expression in the brain tissue.