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论著:降纤酶联用依达拉奉治疗急性脑梗死
Clinical Study of Edaravone-Defibrase Combination in Treatment of Acute Cerebral Infarction
史楠 龙威 伍旭升
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作者单位:上海市浦东新区周浦医院神经内科
中文关键字:急性脑梗死;降纤酶;依达拉奉
英文关键字:Acute cerebral infarction; Defibrase; Edaravone
中文摘要:目的:探讨依达拉奉联用降纤酶治疗急性脑梗死的临床疗效及安全性。方法:发病12 h内的急性脑梗死患者93例,随机分为A组46例和B组47例。A组患者用依达拉奉注射液(30 mg加入0.9%氯化钠液100 mL静脉滴注,2次/d,共14 d)和降纤酶(首剂量为15 U,以后隔日给予5 U,共4次,均加入0.9%氯化钠液250 mL,2~3 h内静脉滴注);B组患者仅用降纤酶治疗。治疗前后对患者进行欧洲脑卒中量表(ESS)神经功能缺损程度评分、日常生活能力(ADL) 评分、急性生理功能和慢性健康状况评分(APACHE) II评分及C反应蛋白(CRP)测定,随访时间3个月。结果:治疗后14 d,2组患者的ESS、ADL、APACHE II和CRP较治疗前有显著改善,A组的各项指标优于B组;A组有效率(67.4%)显著高于B组(40.4%)(P<0.05);3个月病死率2组无显著差异(P>0.05);2组患者均无颅内出血发生,少数患者发生颅外出血,2组差异无统计学意义,所有病例无严重不良反应发生。结论:依达拉奉联用降纤酶治疗急性脑梗死安全、有效。
英文摘要:Objective: To investigate the efficacy and safety of edaravone-defibrase combination in treatment of acute cerebral infarction.Methods: The patients with acute cerebral infarction within 12 hours of stroke onset were divided randomly into two groups:group A(46 cases)and group B(47 cases).Group A were treated with edaravone(30mg,twice a day,for 14 days)and defibrase(initial 15U,subsequent 5U on the 3th,5th,7th,9th day);and group B were treated only with defibrase.The neurological deficit scores of European stroke scale(ESS),activities of daily living(ADL),acute physiology and chronic health evalution II(APACHE) II scores and C-reactive protein(CRP)level were evaluated before and after treatment;the efficacy was evaluated after the treatment. Results: After the 14th day treatment,there were significant difference of all the four variables(ESS,ADL, APACHE II and CRP)in two groups than before treatment,all the four variables of group A were better than group B;the efficient rate of group A(67.4%)was higher than group B(40.4%) (P<0.05);There was no significant difference for the mortality at 3 months between two groups(P>0.05);There were several patients with extracranial hemorrhage and there was no significant difference between two groups(P>0.05),there was no intracranial hemorrhage in all patients;there was no severe adverse reaction in two groups. Conclusions: Edaravone-defibrase combination is effective and safe in treatment of acute cerebral infarction.
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