李俊,庞洪波,胡勇,徐文锐,季学磊,许弘飞
LI Jun,PANG Hongbo,HU Yong,XU Wenrui,JI Xuelei,XU Hongfei

• 1:芜湖市第二人民医院神经内科
• 2:苏州大学

摘要(Abstract)：

目的:探讨丁苯酞氯化钠注射液联合依达拉奉对急性脑梗死患者神经功能及日常生活能力的影响。方法:90例急性脑梗死患者,均分为依达拉奉组、丁苯肽组及两种药物联合组,3组患者在常规急性脑梗死治疗的基础上,分别给与相应药物治疗;于治疗前及治疗2周时,分别采用美国国立卫生研究院制定的卒中量表评分(NIHSS)和日常生活能力量表(Barthel指数)评价患者的神经功能及日常生活能力,比较3组患者治疗2周时的治疗效果及不良反应。结果:治疗前,3组患者NIHSS评分及Barthel指数比较,差异无统计学意义(P>0.05);治疗2周时,3组患者Barthel指数均显著高于治疗前、NIHSS评分显著低于治疗前(P<0.05);联合组患者治疗2周时的Barthel指数显著高于依达拉奉组及丁苯肽组,NIHSS评分显著低于依达拉奉组及丁苯肽组(P<0.05),依达拉奉组、丁苯肽组治疗2周时Barthel指数级及NIHSS评分比较,差异无统计学意义(P>0.05);治疗2周时,联合组患者总有效率显著高于依达拉奉组和丁苯肽组(P<0.05),依达拉奉组与丁苯肽组总有效率比较,差异无统计学意义(P>0.05)。结论:丁苯酞氯化钠注射液联合依达拉奉治疗急性脑梗死治疗效果优于单一丁苯酞氯化钠注射液或依达拉奉用药。
Objective: To explore the effects of butyphthalide sodium chloride injection combined with Edaravone on neurological function and activities of daily living in patients with acute cerebral infarction. Methods: 90 patients with acute cerebral infarction were divided into three groups: Edaravone group,butadiene-butadiene group and two drugs combination group. Three groups of patients were treated with corresponding drugs on the basis of routine treatment of acute cerebral infarction. Before treatment and 2 weeks after treatment,neurologic function and ADL were evaluated by stroke scale( NIHSS) and ADL scale( Barthel index) developed by the National Institutes of Health in the United States. The efficacy and adverse reactions of three groups were compared at 2 weeks of treatment.Results: There was no significant difference in NIHSS score and Barthel index between the three groups before treatment( P > 0. 05). At the 2 weeks of treatment,the Barthel index of the 3 groups was significantly higher than that before treatment,and the NIHSS score was significantly lower than that before treatment( P < 0. 05). The Barthel index in the combined group was significantly higher than that in the Edaravone group and the butadiene-butadiene group at 2 weeks,and NIHSS score was significantly lower than that in Edaravone group and butadiene-butadiene group( P < 0. 05). There was no significant difference in Barthel index and NIHSS score between Edaravone group and butadipine group at 2 weeks( P > 0. 05). At 2 weeks after treatment,the total effective rate in the combined group was significantly higher than that in the Edaravone group and the butadiene-butadiene group( P < 0. 05).There was no significant difference in the total effective rate between Edaravone group and butadiene peptide group( P > 0. 05). Conclusion: The efficacy of butyphthalide sodium chloride injection combined with Edaravone in the treatment of acute cerebral infarction is better than that of butyphthalide sodium chloride injection or Edaravone injection.

关键词(KeyWords)： 脑梗塞,急性;神经功能缺损评分;日常生活能力量表;依达拉奉;丁苯肽
cerebral infarction,acute;neurological impairment score;activity of daily living scale;edaravone;phenylbutoxide

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(81302617);; 安徽省年度重点科研计划项目(1301043052)

作者(Author): 李俊,庞洪波,胡勇,徐文锐,季学磊,许弘飞
LI Jun,PANG Hongbo,HU Yong,XU Wenrui,JI Xuelei,XU Hongfei

DOI: 10.19367/j.cnki.1000-2707.2018.07.015

参考文献(References)：

• [1]陈玉梅.丁苯酞对急性脑梗死患者血清UCH-L1、GFAP及TNF-α水平的影响[J].贵州医科大学学报,2017,42(11):1345-1348.
• [2]DUPLYAKOV V D,ERLIKH D A,DZHINIBALAEVA B Z,et al.Myocardial infarction at the background of left bundle branch block in the record-3 registry-management and prognosis[J].Kardiologiia,2017,57(7):20-26.
• [3]程冉冉,李焰,周燕,等.丁苯酞联合依达拉奉对急性脑梗死患者血清SOD、MDA的影响[J].中国老年学杂志,2014,(11):2974-2975.
• [4]BAUD J M,LUONG S,ROUYER O,et al.Contribution of contrast enhanced ultrasonography in the characterization of carotid lesions[J].J Med Vasc,2017,42(5):301-314.
• [5]刘运平,王慧娟,曹妍,等.丁苯酞氯化钠联合依达拉奉治疗急性期脑梗死的临床疗效研究及安全性评价[J].河北医药,2015,(22):3411-3414.
• [6]MARIAN T,SCHRDER J B,MUHLE P,et al.Pharyngolaryngeal sensory deficits in patients with middle cerebral artery infarction:Lateralization and relation to overall dysphagia severity[J].Cerebrovasc Dis Extra,2017,7(3):130-139.
• [7]SUNADA M,SUZUKI Y,TAKANO T,et al.Emergent thoracic endovascular aortic repair and subxiphoid pericardiotomy for retrograde type a acute aortic dissection with cardiac tamponade;report of a case[J].Kyobu Geka,2017,70(11):960-964.
• [8]刘运平,曹妍,王慧娟,等.丁苯酞氯化钠联合依达拉奉治疗急性脑梗死患者对血清MDA水平和SOD活力的影响[J].河北医药,2015,(23):3561-3563.
• [9]中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):60-61.
• [10]朱燕,卢桂兰,周经霞,等.丁苯酞联合依达拉奉对急性脑梗死患者生活能力的改善[J].血栓与止血学,2016,22(5):514-517.
• [11]LIM J S,KWON H M,KIM S E,et al.Effects of temperature and pressure on acute stroke incidence assessed using a korean nationwide insurance database[J].J Stroke,2017,19(3):295-303.
• [12]吕荣祥,刘郁,张静静,等.丁苯酞治疗急性进展性脑卒中患者45例疗效观察[J].心脑血管病防治,2014,(4):334-336.
• [13]吴顶锋.依达拉奉与丁苯酞联合治疗急性脑梗死45例临床疗效观察[J].山西医药杂志,2016,45(22):2614-2616.
• [14]CHEN K,HOU X,ZHOU Z,et al.The efficacy and safety of endovascular recanalization of occluded large cerebral arteries during the subacute phase of cerebral infarction:A case series report[J].Stroke Vasc Neurol,2017,2(3):124-131.
• [15]梁跃雄,常大川,曹丽,等.依达拉奉联合丁苯酞对脑梗死患者血浆B型脑钠肽前体(NT-pro BNP)和D-二聚体水平的影响[J].解放军医药杂志,2016,28(8):77-80.
• [16]ZHANG Y Z,WANG J,XU F.Circulating miR-29b and miR-424 as prognostic markers in patients with acute cerebral infarction[J].Clin Lab,2017,63(10):1667-1674.
• [18]王慧娟,刘运平,曹妍,等.丁苯酞氯化钠联合依达拉奉治疗急性期脑梗死患者对神经功能缺损评分和日常生活活动能力的影响[J].河北医药,2015,(21):3255-3258.
• [19]HAN J Y,CHOI J W,WANG K C,et al.Coexistence of radiation-induced meningioma and moyamoya syndrome10 years after irradiation against medulloblastoma:A case report[J].J Korean Med Sci,2017,32(11):1896-1902.
• [20]王国印,侯婧.依达拉奉联合丁苯酞治疗急性脑梗死疗效观察及对血清C反应蛋白的影响[J].中国医药,2013,8(8):1079-1080.
• [21]吴赛珍,陈力宇,郑兢,等.丁苯酞注射液治疗分水岭脑梗死伴进展性神经功能恶化疗效观察[J].心脑血管病防治,2016,16(2):153-155.
• [22]HE R X,ZHANG L,ZHOU T N,et al.Safety and necessity of antiplatelet therapy on patients underwent endovascular aortic repair with both stanford type b aortic dissection and coronary heart disease[J].Chin Med J,2017,130(19):2321-2325.

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