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[摘要]
目的 探討注射用丹參多酚酸聯(lián)合尤瑞克林治療急性心源性腦梗死(ACCE)的臨床療效及安全性。方法 選擇駐馬店市中心醫(yī)院收治的102例ACCE患者,隨機(jī)分為對(duì)照組和觀(guān)察組,每組各51例,全部患者均予以靜脈滴注0.5 g胞磷膽堿鈉注射液+250 mL生理鹽水,每日1次,予以口服100 mg阿司匹林腸溶片+20 mg阿托伐他汀片,每日1次。對(duì)照組患者在以上治療的基礎(chǔ)上予以靜脈滴注0.15 PNA尤瑞克林+100 mL生理鹽水,每日1次。觀(guān)察組患者在對(duì)照組治療的基礎(chǔ)上予以靜脈滴注100 mg丹參多酚酸+250 mL生理鹽水進(jìn)行治療,每日1次。一個(gè)療程為14 d。觀(guān)察指標(biāo):(1)對(duì)兩組患者治療前后的神經(jīng)功能缺損情況、功能恢復(fù)水平進(jìn)行觀(guān)察分析;(2)對(duì)兩組患者的臨床療效進(jìn)行評(píng)價(jià);(3)對(duì)兩組患者治療前后的血液流變學(xué)指標(biāo)(全血高切黏度、全血低切黏度、血漿黏度、紅細(xì)胞壓積、纖維蛋白原、血小板黏附率)進(jìn)行記錄比較;(4)對(duì)兩組患者治療過(guò)程中的不良反應(yīng)(惡心、嘔吐、頭暈、頭痛)進(jìn)行統(tǒng)計(jì)分析。結(jié)果 兩組患者治療后的NIHSS評(píng)分及mRS評(píng)分均顯著低于治療前(P<0.01),且觀(guān)察組患者治療后的NIHSS評(píng)分均顯著低于對(duì)照組(P<0.01)。觀(guān)察組的總有效率顯著高于對(duì)照組(96.08% vs 76.47%,P<0.01)。兩組患者治療后的全血高切黏度、全血低切黏度、血漿黏度、紅細(xì)胞壓積、纖維蛋白原水平及血小板黏附率顯著低于治療前(P<0.05),且觀(guān)察組患者治療后的全血高切黏度、全血低切黏度、血漿黏度、紅細(xì)胞壓積、纖維蛋白原水平及血小板黏附率顯著低于對(duì)照組(P<0.05)。兩組患者之間的不良反應(yīng)率比較差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論 ACCE緩和采用注射用丹參多酚酸聯(lián)合尤瑞克林較單純采取尤瑞克林臨床療效較好,能夠顯著降低患者的血液黏滯度,改善患者的神經(jīng)功能缺損情況,提高患者治療后的日常生活功能水平,且不良反應(yīng)發(fā)生率未發(fā)生明顯變化,用藥安全性好。
[Key word]
[Abstract]
Objective To explore the clinical efficacy and safety of Salvianolic Acids for Injection combined with urinary kallikrein in the treatment of acute cardiogenic cerebral embolism (ACCE). Methods One hundred and two patients with ACCE in our hospital were randomly divided into the control group and the observation group, 51 cases in each group. All patients were given intravenous drip of 0.5 g citicoline sodium injection + 250 mL saline and oral administration of 100 mg Aspirin enteric-coated tablets +20 mg atorvastatin tablet, once a day. One course of treatment lasted 14 days. The neurological deficits and functional recovery levels of the two groups before and after treatment were observed and analyzed. The clinical efficacy of two groups of patients was evaluated. The hemorrheology indexes (Whole blood high shear viscosity, whole blood low shear viscosity, plasma viscosity, hematocrit, fibrinogen, platelet adhesion rate) of the two groups before and after treatment were recorded and compared. The adverse reactions (nausea, vomiting, dizziness, headache) in the two groups were analyzed statistically. Results The NIHSS scores and mRS scores of the two groups after treatment were significantly lower than those before treatment (P<0.01), the NIHSS score of the observation group after treatment was significantly lower than that of the control group (P<0.01). The total effective rate of the observation group was significantly higher than that of the control group (96.08% vs 76.47%, P<0.01). The total blood viscosity, low shear viscosity, plasma viscosity, hematocrit, fibrinogen level and platelet adhesion rate after treatment in the two groups were significantly lower than those before treatment (P<0.05), the total blood viscosity, low shear viscosity, plasma viscosity, hematocrit, fibrinogen level and platelet adhesion rate in the observation group were significantly lower than those in the control group (P<0.05). There was no significant difference in the rate of adverse reactions between the two groups. Conclusion Salvianolic Acids for Injection combined with urinary kallikrein is better than pure urinary kallikrein in treating acute cardiogenic cerebral embolism, it can significantly reduce the blood viscosity of patients, improve the neurological deficit and improve the daily life function after treatment. The incidence of adverse reactions did not increase significantly, so its safety can also be proved.
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