论文部分内容阅读
目的研究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。方法选择2005—2007年复旦大学附属上海市第五人民医院急诊科发病12h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组患者使用依达拉奉注射液(30mg加入生理盐液100mL静脉滴注,每日2次,共14d)和降纤酶(首剂量为15U,以后隔日5U,共4次,均加入生理盐液250mL,2～3h内静脉滴注);B组仅使用降纤酶治疗。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)、APACHEⅡ评分及C-反应蛋白(CRP)的测定,治疗后进行疗效评定,进行为期3个月的随访。结果在治疗后14d,两组患者的ESS、ADL、A-PACHEⅡ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%)高于B组(40.4%)(P<0.05);两组的3个月病死率没有显著差异(P>0.05);两组患者均无颅内出血发生,少数患者发生颅外出血,两组没有显著差异,所有病例无严重不良反应发生。结论依达拉奉联用降纤酶能够安全有效的治疗急性脑梗死患者。
Objective To study the clinical efficacy and safety of edaravone combined with defibrase in the treatment of acute cerebral infarction. Methods Ninety-three patients with acute cerebral infarction within 12 hours of emergency department of Shanghai Fifth People’s Hospital Affiliated to Fudan University from 2005 to 2007 were randomly divided into A group (46 cases) and B group (47 cases). A group of patients with edaravone injection (30mg intravenous infusion of 100mL saline, intravenous drip twice a day, a total of 14d) and defibrase (the first dose of 15U, 5U every other day, a total of 4 times, were added to the physiology Saline 250mL, 2 ~ 3h intravenous infusion); B group only defibrase treatment. Before and after treatment, the patients were scored for neurological deficit score, daily living ability (ADL), APACHE II score and C-reactive protein (CRP) in European Stroke Scale (ESS), and the curative effect was evaluated after 3 months Follow-up. Results At 14 days after treatment, ESS, ADL, A-PACHEⅡ and CRP in both groups were significantly improved compared with those before treatment, and the indexes in group A were better than those in group B. The effective rate (67.4%) in group A was higher than that in group B 40.4%) (P <0.05). There was no significant difference in the three-month mortality rates between the two groups (P> 0.05). No intracranial hemorrhage occurred in both groups, and extracranial hemorrhage occurred in a few patients. There was no significant difference between the two groups. No serious adverse reactions occurred. Conclusion Edaravone combined with defibrase can safely and effectively treat patients with acute cerebral infarction.