单唾液酸四己糖神经节苷脂联合依达拉奉治疗急性脑梗死的疗效观察

目的观察单唾液酸四己糖神经节苷脂(GM-1)联合依达拉奉治疗急性脑梗死(ACI)的临床疗效。方法 ACI患者94例,按照随机数字表法分为观察组和对照组各47例。对照组在常规治疗的基础上加用神经保护剂GM-1;观察组在对照组的基础上加用依达拉奉;2组疗程均为14d。观察2组治疗前后神经功能缺损评分(NIHSS评分)、日常生活活动能力指数(Barthel指数)和血清hs-CRP水平的变化,评价临床疗效。结果治疗前2组NIHSS评分、Barthel指数及血清hs-CRP水平差异无统计学意义(P0.05);治疗后2组NIHSS评分、Barthel指数及血清hs-CRP水平均较治疗前明显改善,观察组改善情况明显优于对照组,差异有统计学意义(P0.05);观察组和对照组的临床总有效率分别为89.36%、72.34%,观察组明显优于对照组,差异有统计学意义(χ2=2.846,P0.05)。结论 GM-1联合依达拉奉能明显减轻ACI患者炎性反应,改善神经功能和日常生活活动能力,疗效显著,值得临床推广应用。     

依达拉奉注射液与神经节苷脂钠注射液治疗急性脑梗死的临床疗效对比

目的比较依达拉奉注射液与单唾液酸四己糖神经节苷脂钠注射液治疗急性脑梗死的临床疗效。方法选择临床收治210例急性脑梗死患者,随机分成2组。观察组给予依达拉奉注射液治疗,30mg/次,100mL生理盐水稀释后静滴,2次/d;对照组给予单唾液酸四己糖神经节苷脂钠注射液治疗,40mg/次,100mL生理盐水稀释后静滴,1次/d。观察治疗后神经功能缺损量表(NIHSS)评分及日常生活活动能力量表(BI)评分,比较2组的临床疗效。结果 2组疗效比较差异无统计学意义(P0.05);2组治疗7、14、28d后NHISS评分均低于治疗前,BI评分均高于治疗前,治疗后同一时间评分比较差异均无统计学意义(P0.05)。2组均未发生任何严重不良反应。结论依达拉奉注射液与单唾液酸四己糖神经节苷脂钠注射液治疗急性脑梗死的临床疗效相当,安全性高,值得推广应用。     

依达拉奉联合神经节苷脂治疗急性脑梗死疗效观察

目的探讨依达拉奉联合单唾液酸四己糖神经节苷脂治疗急性脑梗死的临床疗效和安全性。方法将60例急性脑梗死随机、单盲分为2组:治疗组应用依达拉奉、单唾液酸四己糖神经节苷脂及常用脑血管病治疗剂治疗;对照组给予常用脑血管病治疗剂治疗,疗程14 d。结果治疗后2组神经功能缺损评分均有改善,但治疗组更明显。治疗组总有效率86.7%,对照组总有效率60%,2组比较差异有统计学意义(P<0.05)。结论依达拉奉联合单唾液酸四己糖神经节苷脂治疗急性脑梗死安全有效。     

依达拉奉联合神经节苷脂治疗急性脑梗死疗效分析

脑梗死是临床常见的缺血性脑疾病,多因脑部血液供应障碍,使局部脑组织发生不可逆损害所致[1]。脑梗死致残率及致死率均较高,严重危害患者的生命健康及生活质量。脑梗死治疗的关键在于改善脑供血,恢复脑组织功能。笔者对49例急性脑梗死患者采用依达拉奉联合神经节苷脂治疗效果显著,现报告如下。     

依达拉奉治疗老年大面积脑梗死疗效观察

依达拉奉是新型脑保护剂,具有消除自由基抑制脂质过氧化的作用,可抑制脑细胞的过氧化从而发挥脑保护作用。国内外多项临床研究,证实该药治疗急性脑梗死安全有效。但国外已有报道该药在老年患者中可发生急性肾衰、肝炎、横纹肌溶解等不良反应,使该药在老年患者中的应用受到限制,大面积脑梗死是脑梗死中较严重的类型,病情凶险,病死率及致残率均很高,临床治疗效果欠佳。故我们对依达拉奉治疗老年大面积脑梗死的疗效和安全性进行观察研究,现报道如下。     

神经节苷脂联合依达拉奉治疗急性脑出血40例疗效观察

目的观察联合应用神经节苷脂和依达拉奉治疗急性脑出血的临床疗效。方法选取78例急性脑出血患者,随机选择40例为观察组,给予常规治疗加神经节苷脂和依达拉奉,余38例为对照组,给予常规治疗加依达拉奉,所有患者入院后均计算头颅CT血肿及水肿区的面积,ADL日常生活能力量表评分,同时对患者神经功能缺损进行评分,治疗结束后复查,对结果对比分析。结果与治疗前相比,2组治疗后效果均明显改善,神经功能缺损评分明显降低,手术后2组患者头颅CT血肿及水肿区的面积缩小,治疗后ADL日常生活能力量表评分明显升高,治疗后观察组较对照组改善较为明显。结论联合使用神经节苷脂和依达拉奉治疗急性脑出血较单一使用依达拉奉临床症状改善更明显,值得临床推广应用。     

依达拉奉联合神经节苷脂早期治疗急性脑梗死的临床分析

目的观察依达拉奉联合单唾液酸四己糖神经节苷脂治疗急性脑梗死的临床疗效。方法选择70例发病时间在72h内的急性脑梗死患者,随机分为治疗组35例,对照组35例。治疗组在对照组基础上加用依达拉奉30mg加入0.9%氯化钠注射液100ml静脉滴注,每天2次,连用14d。对照组给予基础治疗和唾液酸四己糖神经节苷脂40mg加入0.9%氯化钠注射液150ml静脉滴注,每天1次,连用14d。比较两组治疗前后的患者临床神经功能缺损程度评分和临床疗效。结果治疗前两组临床神经功能缺损评分无明显差异。治疗14d后,治疗组评分低于对照组。治疗组临床疗效总有效率为91.4%,对照组为71.1%,差异有统计学意义(P=0.016)。结论依达拉奉联合单唾液酸四己糖神经节苷脂早期治疗急性脑梗死有显著疗效。     

依达拉奉联合樯丙酯治疗急性脑梗死的疗效分析

目的研究依达拉奉、梧丙酯联合应用治疗急性脑梗死的临床疗效。方法选择120例急性脑梗死患者，随机分为对照组60例和治疗组60例。对照组应用复方丹参，治疗组依达拉奉、桔丙酯联合应用，2组其他内科治疗相同。结果14d和30d评定神经功能缺损的有效率对照组分别为20．0％和40．0％，依达拉奉、桔丙酯联合治疗组为43．3％和76．7％，2组间治疗后14d、30d的神经功能缺损评分值比较，均有显著性差异（P〈0．05）。治疗组治疗后的神经功能恢复明显优于对照组（P〈0．05）。结论依达拉奉联合梏丙酯治疗急性期脑梗死的疗效显著。     

单唾液酸四己糖神经节苷脂治疗急性脑梗死疗效观察

目的探讨单唾液酸四己糖神经节苷脂（GM-1,商品名澳甘）治疗急性脑梗死的疗效。方法 257例急性脑梗死患者随机分为治疗组129例及对照组128例,治疗组除常规治疗外给予神经节苷脂注射液100mg,加入0.9%氯化钠注射液250mL,1次/d,连续治疗2周。2组分别在治疗前、后28d进行NIHSS评分。结果治疗组好转率为90.6%,明显高于对照组（70.7%）,2组比较差异有统计学意义（P〈0.05）;治疗过程中未发现明显不良反应。结论 GM-1治疗急性脑梗死疗效显著,能促进神经功能早期恢复,提高患者生活质量。     

神经节苷脂联合依达拉奉治疗老年急性脑梗死的效果分析

目的探讨神经节昔脂联合依达拉奉治疗老年急性脑梗死(ACI)的效果。方法 70例老年ACI患者随机分为观察组及对照组各35例,对照组给予依达拉奉治疗,观察组在此基础上加用神经节昔脂注射液进行治疗,对比2组治疗前后的神经功能缺损评分(NIHSS)情况。结果治疗后2组NIHSS均较治疗前明显降低,组间比较差异有统计学意义(P0.05)。治疗第7天,观察组神经功能缺损评分低于对照组,差异有统计学意义(P0.05)。结论神经节昔脂联合依达拉奉应用于老年ACI的治疗,可明显改善患者的神经功能受损情况,提高治疗的效果。     

依达拉奉联合尼莫地平对急性大面积脑梗死相关生化指标的影响

目的探讨依达拉奉与尼莫地平对急性大面积脑梗死患者相关生化指标的影响,并评价其安全性。方法选择101例急性大面积脑梗死患者为研究对象,采用计算机数字随机法分为对照组(53例)和观察组(48例)。对照组采用减轻脑水肿、强化他汀以及抗血小板聚集等常规治疗,观察组在对照组基础上给予依达拉奉与尼莫地片联合用药。2组疗程均为15d。观察2组临床疗效、治疗前后血氧饱和度(SpO_2)、血红蛋白(Hb)、总血红蛋白(THb)、还原血红蛋白(HHb)及不良反应发生情况。结果治疗2周后,2组SpO_2、THb、HHb均显著高于同组治疗前,且观察组高于对照组,差异有统计学意义(P0.05);Hb低于同组治疗前,差异有统计学意义(P0.05),2组间比较差异无统计学意义(P0.05)。观察组与对照组总有效率分别为95.83%、73.58%,2组比较差异有统计学意义(χ~2=13.886,P0.05)。治疗期间2组均无明显不良反应。结论在常规治疗基础上,依达拉奉与尼莫地平联合治疗急性大面积脑梗死具有较显著的临床效果,可有效改善患者的神经功能缺损程度,且具有较高的安全性。     

依达拉奉治疗急性脑梗死的疗效观察

急性脑梗死是常见的老年病，40岁以上开始发病，其发病率亦随年龄增高而增高，60～75岁发病率为1％-2％，75岁以上3％。该病急性期死亡率为5％～15％。目前对该病防治的药物及方法虽然很多，但迄今为止，没有任何动物模型或对已经形成的梗死灶都能取得较为理想一致的疗效。我们于2004—06-2005—06应用依达拉奉治疗急性脑梗死患者60例，效疗确切，现报告如下。     

依达拉奉治疗急性脑梗死的疗效分析

目的探讨自由基清除剂依达拉奉在急性脑梗死患者治疗中的有效性。方法采用随机分组方法将130例脑梗死患者分为治疗组及对照组,对照组常规运用拜阿司匹林口服等,治疗组在此基础上加用依达拉奉,采用美国国立卫生研究院脑卒中量表（NIHSS）和患者日常生活能力（ADL）进行疗效评定。结果治疗组神经功能缺损评分NIHSS明显低于对照组,日常生活能力（ADL）明显高于对照组,两组均有显著差异（P〈0.05）。结论依达拉奉作为自由基清除剂治疗脑梗死疗效确切、可靠。     

依达拉奉治疗急性脑梗死的疗效观察

目的了解依达拉奉治疗急性脑梗死的疗效。方法对57例急性脑梗死病人分成依达拉奉治疗组（n=31）和对照组（n=26），疗效评定按《脑卒中患者临床功能缺失程度评分标准》评分。结果治疗组有效率为90．3％优于对照组61.5％（P〈0．01）。起效时间治疗组比对照组早。结论依选拉奉治疗急性脑梗死疗效确切，安全性高。     

Reduction of cerebral edema with GM1 ganglioside

Administration of exogenous gangliosides has been reported to accelerate neurite outgrowth in vitro, and to enhance peripheral nerve regeneration and central nervous system recovery subsequent to damage. After injury, facilitation of CNS recovery with GM1 ganglioside treatment has been postulated to be due to enhanced neuronal regeneration. Since maximal recovery is achieved when experimental animals are treated before injury with GM1 ganglioside, an alternative or parallel mechanism is that gangliosides are "protecting" the CNS by limiting the extent of damage (ie, cell loss, process degeneration, membrane disruption). This may be due to a reduction in the edema subsequent to injury. In this study, rats were treated for 2 days with 20 mg/kg/day of GM1 ganglioside. On the third day they were subjected to a unilateral lesion (mechanical) of one cerebral hemisphere and given another 20 mg/kg of GM1. On the fourth day brains were removed for analysis of edema resulting from the injury. In treated animals there was a significant reduction in edema as measured either in the entire injured hemisphere (23%) or in the area of injury (33%). No effect was seen outside the damaged area. Since exogenous gangliosides can spontaneously "insert" into membranes, it is postulated that the effect of the GM1 may be due to alterations of membrane processes (eg, lipid hydrolysis, phospholipase activation, levels and membrane action of arachidonic acid, ionic permeation) that are characteristic of edema.     

Effect of GM1 ganglioside after focal cerebral ischemia in halothane-anesthetized cats

The effect of the ganglioside GM1 was studied in a focal cerebral ischemia model in 30 cats consisting of 2 hours of middle cerebral artery occlusion followed by 4 hours of recirculation. The cerebrocortical electrical activity, extracellular potassium activity, and microcirculation indicated by NAD/NADH fluorescence were measured during occlusion as well as during recirculation in the core of the middle cerebral artery territory, while the cerebral metabolic rate for glucose (ICMRgl) was measured at the end of recirculation. The cats were classified into either mildly or moderately severe stroke groups based on the depression of the cerebrocortical electrical activity on the occluded side. Of 12 cats with only a mild stroke, six were administered GM1 intravenously 30 minutes after occlusion, while six cats were not treated. Of 12 cats with a moderate stroke, six were treated and six were left untreated. In six additional cats, only a sham insult was undertaken. In the cats with mild stroke, GM1 treatment significantly increased lCMRgl in the peripheral middle cerebral artery territory compared with the untreated cats; for the six treated cats, lCMRgl was normalized toward the control level, whereas it was depressed in the six untreated cats. There were no other significant effects of GM1 treatment on the other measured parameters. A potential protective effect of anesthesia is discussed.     

依达拉奉对急性脑梗死再灌注损伤保护临床分析

目的探讨依达拉奉对急性脑梗死再灌注损伤保护。方法选取我院2006-01～2009-12收治的312例急性脑梗死患者随机分为治疗组162例,对照组150例。对照组组采用:基础治疗,治疗组基础治疗加用依达拉奉治疗,观察神经功能缺损评分变化及临床疗效。结果治疗组和对照组2组治疗5 d、15 d后神经功能缺损程度评分比较P0.05有显著的差异性。2组临床疗效比较,显效率、总有效率P0.05有显著差异性。结论依达拉奉是一种强效的羟自由基清除剂及抗氧化剂,能够有效的对脑缺血再灌注损伤起到保护作用,防止再灌注损伤,减少脑细胞凋亡,减轻临床症状,促进疾病康复。     

Trial of ganglioside GM1 in acute stroke.

Ganglioside GM1 (100 mg) was given daily by intramuscular injection for 28 days in a double-blind placebo controlled trial of acute stroke. No significant difference was detected in a 6 month follow-up period between well matched control and active groups. Although the number of patients studied was small the findings are believed to indicate that GM1 is unlikely to be of value in the treatment of acute stroke in the dose and route of administration used.