抗栓药物联合治疗急性脑梗死

Objective To investigate the efficacy and safety of combinative antithrombotic therapy for patients with acute cerebral infarction who were not eligible for thrombolysis. Methods Eighty-three patients with acute cerebral infarction at six to twelve hours after the onset were randomly allocated into two groups : treat-ment group(n=46) recived batroxobin, aspirin and dipyridamole; control group(n=37) received aspirin. Neuro-logic impairment scole was measured at days 0, and 14. Barthel index of the two groups were observed at days 0 and 90. Blood coagulation action of the treatment group was also measured at days 0,5 and 11. Results In treatment group, the nervous function defect integral examined 14 d after trearment (12.7±6.4 )was markedly decreased than that of control group (20.1±7.2). A remarkable difference (P<0.01 ) was noticed between them. The Barthel index of the treatment group at 90 d after trearment (86.8±12.9 )was markedly increased than that of control group(43.4±15.1 ) (P<0.01 ). The total effective rate of treatment group and control group were 93.5% and 56.8% respectively( P<0.01). Conclusion The efficacy of combinative antithrombotic therapy for patients with acute cerebral infarction who were not eligible for thrombolysis is better than aspirin a-lone. Further more, the risk of bleeding may not increase in combinative antithrombotic therapy.     

视网膜缺血病人的脑内微栓子

在这项研究中,我们采用经颅多谱勒(TCD)检测了包括短暂性单眼失明(TMB)、视网膜中央或分枝动脉栓塞以及缺血性眼病在内的具有临床证据的视网膜缺血病人中脑微栓子的发生频率,并且评定了与颈动脉狭窄的相关性。 1993年3月29日至1996年7月31日期间,波士顿医学院神经血管研究所采TC-2000或TC-2020TCD仪,对331例病人的453条颅内动脉进行了微栓子信号(MES)的检测,除外其中颈动脉内膜切除术侧的大脑中动脉(MCAs),并删除资料丢失或不完整、伴有其他脑血管疾病及有心脏栓子来源的病例,对符合标准的163例病人的186条MCAs进行MES检测。 以44例同侧视网膜缺血病人的45条MCAs作为研究组,其中包括:单纯TMB病人的30条MCAs,TMB同时伴有同侧大脑半球缺血或梗死7例,视网膜中央