Objective:Study the clinical effect of atorvastatin combined with clopidogrel on patients with progressive cerebral infarction of intracranial aortic stenosis.Methods: Chose eighty-eight patients with progressive cere...Objective:Study the clinical effect of atorvastatin combined with clopidogrel on patients with progressive cerebral infarction of intracranial aortic stenosis.Methods: Chose eighty-eight patients with progressive cerebral infarction in our hospital from June 2014 to October 2015. They were randomly divided into study group and study group, 44 cases in each group. The patients in the control group were treated with oral clopidogrel. On the basis of this, the patients in the study group were treated with atorvastatin;all patients were treated for 4 weeks. Compared the total effective rate, adverse reaction rate, coagulation function index and blood lipid level between the two groups, and compared the NIHSS score and daily life ability (ADL) score between the two groups before and after treatment.Results: The total effective rate (90.90%) was significantly higher in the study group than in the control group (72.73%). After treatment, the NIHSS score of the study group was significantly lower than that of the control group. The levels of LDL-C, TG and TC in the study group were significantly lower than those in the control group, and HDL-C was significantly higher than that in the control group. There was no significant difference between the two groups.Conclusion: Clopidogrel combined with atorvastatin has a significant effect on the patients with intracranial large artery stenosis and improve the neurological function and quality of life. It is safe and reliable. It is worthy to be popularized.展开更多
Background and Purpose: Decompressive craniectomy is a surgery used to remove a large bone flap and opening the dura to allow edematous brain tissue to bulge extracranially. However, the efficacy of decompressive surg...Background and Purpose: Decompressive craniectomy is a surgery used to remove a large bone flap and opening the dura to allow edematous brain tissue to bulge extracranially. However, the efficacy of decompressive surgery to reduce the mortality and improve the outcome in patients with refractory intra-cranial pressure is still unclear. We investigated whether decompressive crani-ectomy is associated with improved conscious state and survival in patients with severely raised intracranial pressure and resistant to conservative management. Methods: We studied 20 patients with clinical and radiological evidence of increased intracranial pressure & indicated for decompressive crani-ectomy. All patients were followed postoperatively in ICU with serial follow up (CT). Consciousness level was evaluated using the Glasgow Coma Scale and Glasgow outcome score. Results: The overall mortality was 11 cases (55%), two cases remain in a vegetative state (10%), one case (5%) was severely disabled and six cases (30%) discharged with mild disability. Conclusion: In 20 cases with severely raised intracranial pressure resistant to conservative management Decompressive Craniectomy allowed (30 %) of cases to be discharged from hospitals with mild degree of disability for rehabilitation.展开更多
目的探讨脑梗死伴颅内动脉粥样硬化性狭窄的影响因素。方法选取脑梗死住院患者464例,根据头颅MRA和颈部CEMRA结果分为单纯颅内动脉狭窄(ICAS)组199例、单纯颅外动脉狭窄(ECAS)组47例、颅内合并颅外动脉狭窄(IECAS)组113例和无颅内颅外...目的探讨脑梗死伴颅内动脉粥样硬化性狭窄的影响因素。方法选取脑梗死住院患者464例,根据头颅MRA和颈部CEMRA结果分为单纯颅内动脉狭窄(ICAS)组199例、单纯颅外动脉狭窄(ECAS)组47例、颅内合并颅外动脉狭窄(IECAS)组113例和无颅内颅外动脉狭窄(NCAS)组105例;其中ICAS组颅内动脉狭窄率≥50%135例、<50%64例。测定与比较以上4组患者间血清TG、TC、LDL-C、HDL-C、载脂蛋白B(apo B)、载脂蛋白A1(apo A1)、尿酸(UA)和同型半胱氨酸(Hcy)等指标的差异,采用单因素分析和多因素logistic回归分析脑梗死伴颅内动脉粥样硬化性狭窄的影响因素。结果以上4组患者平均年龄,高血压、糖尿病患病情况,TC、LDL-C水平,apo A1、apo B、apo B/apo A方面比较,差异均有统计学意义(均P<0.05)。颅内外动脉狭窄分布显示,颅外血管病变以颈内动脉颅外段和椎动脉颅外段为主,颅内动脉病变以大脑中动脉和颈内动脉颅内段为主。多支颅内动脉狭窄患者的a p o B水平明显高于单支颅内动脉狭窄患者(P<0.05)。a p o B(OR=8.821)、a p o B/a p o A1(OR=10.149)和吸烟(OR=2.093)是脑梗死伴颅内动脉粥样硬化性狭窄的影响因素。结论 apo B、apo B/apo A1是颅内动脉粥样硬化性狭窄的独立危险因素,可能成为今后临床上筛查与治疗高危人群的靶点。展开更多
文摘Objective:Study the clinical effect of atorvastatin combined with clopidogrel on patients with progressive cerebral infarction of intracranial aortic stenosis.Methods: Chose eighty-eight patients with progressive cerebral infarction in our hospital from June 2014 to October 2015. They were randomly divided into study group and study group, 44 cases in each group. The patients in the control group were treated with oral clopidogrel. On the basis of this, the patients in the study group were treated with atorvastatin;all patients were treated for 4 weeks. Compared the total effective rate, adverse reaction rate, coagulation function index and blood lipid level between the two groups, and compared the NIHSS score and daily life ability (ADL) score between the two groups before and after treatment.Results: The total effective rate (90.90%) was significantly higher in the study group than in the control group (72.73%). After treatment, the NIHSS score of the study group was significantly lower than that of the control group. The levels of LDL-C, TG and TC in the study group were significantly lower than those in the control group, and HDL-C was significantly higher than that in the control group. There was no significant difference between the two groups.Conclusion: Clopidogrel combined with atorvastatin has a significant effect on the patients with intracranial large artery stenosis and improve the neurological function and quality of life. It is safe and reliable. It is worthy to be popularized.
文摘Background and Purpose: Decompressive craniectomy is a surgery used to remove a large bone flap and opening the dura to allow edematous brain tissue to bulge extracranially. However, the efficacy of decompressive surgery to reduce the mortality and improve the outcome in patients with refractory intra-cranial pressure is still unclear. We investigated whether decompressive crani-ectomy is associated with improved conscious state and survival in patients with severely raised intracranial pressure and resistant to conservative management. Methods: We studied 20 patients with clinical and radiological evidence of increased intracranial pressure & indicated for decompressive crani-ectomy. All patients were followed postoperatively in ICU with serial follow up (CT). Consciousness level was evaluated using the Glasgow Coma Scale and Glasgow outcome score. Results: The overall mortality was 11 cases (55%), two cases remain in a vegetative state (10%), one case (5%) was severely disabled and six cases (30%) discharged with mild disability. Conclusion: In 20 cases with severely raised intracranial pressure resistant to conservative management Decompressive Craniectomy allowed (30 %) of cases to be discharged from hospitals with mild degree of disability for rehabilitation.
文摘目的探讨脑梗死伴颅内动脉粥样硬化性狭窄的影响因素。方法选取脑梗死住院患者464例,根据头颅MRA和颈部CEMRA结果分为单纯颅内动脉狭窄(ICAS)组199例、单纯颅外动脉狭窄(ECAS)组47例、颅内合并颅外动脉狭窄(IECAS)组113例和无颅内颅外动脉狭窄(NCAS)组105例;其中ICAS组颅内动脉狭窄率≥50%135例、<50%64例。测定与比较以上4组患者间血清TG、TC、LDL-C、HDL-C、载脂蛋白B(apo B)、载脂蛋白A1(apo A1)、尿酸(UA)和同型半胱氨酸(Hcy)等指标的差异,采用单因素分析和多因素logistic回归分析脑梗死伴颅内动脉粥样硬化性狭窄的影响因素。结果以上4组患者平均年龄,高血压、糖尿病患病情况,TC、LDL-C水平,apo A1、apo B、apo B/apo A方面比较,差异均有统计学意义(均P<0.05)。颅内外动脉狭窄分布显示,颅外血管病变以颈内动脉颅外段和椎动脉颅外段为主,颅内动脉病变以大脑中动脉和颈内动脉颅内段为主。多支颅内动脉狭窄患者的a p o B水平明显高于单支颅内动脉狭窄患者(P<0.05)。a p o B(OR=8.821)、a p o B/a p o A1(OR=10.149)和吸烟(OR=2.093)是脑梗死伴颅内动脉粥样硬化性狭窄的影响因素。结论 apo B、apo B/apo A1是颅内动脉粥样硬化性狭窄的独立危险因素,可能成为今后临床上筛查与治疗高危人群的靶点。
