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1.
目的探讨参七脑康胶囊联合奥扎格雷钠氯化钠注射液治疗急性脑梗死的临床疗效。方法选取2016年1月—2017年12月天津市宁河区医院收治的100例急性脑梗死患者作为研究对象,将患者随机分为对照组和治疗组,每组各50例。对照组患者静脉滴注奥扎格雷钠氯化钠注射液,250 mL/次,2次/d。治疗组在对照组治疗的基础上口服参七脑康胶囊,2 g/次,3次/d。2周为1个疗程,两组均治疗2个疗程。观察两组患者的临床疗效,同时比较两组治疗前后的美国国立卫生研究院卒中量表(NIHSS)评分、简易智力状态检查量表(MMSE)评分、Barthel指数和血液流变学指标。结果治疗后,治疗组的总有效率为92.00%,显著高于对照组的74.00%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者NIHSS评分显著降低,MMSE评分和Barthel指数显著升高,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组NIHSS评分明显低于对照组,MMSE评分和Barthel指数显著高于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者红细胞压积(HCT)、全血高切黏度(HBV)、全血低切黏度(LBV)、血浆比黏度(PV)和纤维蛋白原(FIB)水平均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组患者血液流变学指标水平明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论参七脑康胶囊联合奥扎格雷钠氯化钠注射液治疗急性脑梗死的具有较好的临床疗效,可改善患者神经损伤情况和血液流变状态,安全性较高,具有一定的临床推广使用价值。  相似文献   

2.
赵妍  田冲 《现代药物与临床》2018,33(11):2840-2843
目的探讨芪血通络片联合硫酸氢氯吡格雷片治疗脑梗死的临床疗效。方法选取2017年5月—2018年5月在新疆医科大第一附属医院十二师分院进行治疗的脑梗死患者118例为研究对象,将所有患者随机分为对照组和治疗组,每组各59例。对照组口服硫酸氢氯吡格雷片,2片/次,1次/d;治疗组在对照组治疗的基础上口服芪血通络片,4片/次,3次/d。所有患者均治疗90 d。观察两组患者的临床疗效,同时比较治疗前后两组的美国国立卫生研究院卒中量表(NIHSS)评分、Fugl-Meyer运动功能评分法(FMA)评分、BI指数评分、卒中专门生存质量量表(SS-QOL)评分、血脂和血液流变学指标。结果治疗后,对照组和治疗组的总有效率分别为78.1%、91.5%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者NIHSS评分明显降低,FMA评分、BI指数和SS-QOL评分明显增加,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组上述评分显著优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者血脂TC水平、血浆比黏度、高切黏度、红细胞压积均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组患者血脂和血液流变指标显著低于对照组,两组比较差异具有统计学差异(P0.05)。结论芪血通络片联合硫酸氢氯吡格雷片治疗脑梗死具有较好的临床疗效,可显著提高患者的神经功能、生活能力和生活质量,改善血脂和血液流变指标,安全性好,具有一定的临床推广应用价值。  相似文献   

3.
目的探讨阿加曲班联合氯吡格雷治疗大动脉粥样硬化性脑梗死的临床疗效及对血清炎性因子影响。方法选取2013年1月—2014年9月天津海滨人民医院神经内科住院的大动脉粥样硬化性脑梗死患者160例,随机分为对照组和治疗组,每组80例。对照组在常规治疗的基础上口服硫酸氢氯吡格雷片,1片/次,1次/d。治疗组加用阿加曲班注射液,第1、2天每天用阿加曲班注射液60 mg,以500 m L生理盐水稀释,24 h持续静脉滴注;其后5 d每天用阿加曲班注射液10 mg以250 m L生理盐水稀释,分早晚2次持续静脉滴注,每次3 h。治疗组其他治疗同对照组。两组均连续治疗14 d。比较两组的临床疗效,比较两组患者治疗前,治疗7、14 d的NIHSS评分和Barthel指数,同时比较治疗前,治疗3、7 d时两组肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)的变化。结果治疗组与对照组总有效率分别为91.25%、77.50%,两组比较差异有统计学意义(P0.05)。两组治疗7、14 d时NIHSS评分均较同组治疗前降低,Barthel指数升高,同组治疗前后差异有统计学意义(P0.05)。治疗后,治疗组NIHSS评分低于对照组,Barthel指数高于对照组,两组比较差异有统计学意义(P0.05)。治疗3、7 d,两组患者炎症因子IL-8和TNF-α均较治疗前显著下降,同组治疗前后差异有统计学意义(P0.05);治疗后,治疗组这两个炎症因子均较对照组低,两组比较差异有统计学意义(P0.05)。结论阿加曲班联合氯吡格雷治疗大动脉粥样硬化性脑梗死具有较好的临床疗效,可降低NIHSS评分和炎症因子TNF-α、IL-8,同时能提高患者的Barthel指数,值得临床推广应用。  相似文献   

4.
目的探讨养血清脑颗粒联合丁苯酞软胶囊治疗轻中度脑梗死的临床疗效。方法选取2017年1月—2018年12月在三门峡市中心医院就诊的92例轻中度脑梗死患者为研究对象,按照随机数字表法将全部患者分为对照组和治疗组,每组各46例。对照组口服丁苯酞软胶囊,200 mg/次,3次/d。治疗组在对照组治疗的基础上温水冲服养血清脑颗粒,4 g/次,3次/d。两组患者连续治疗20 d。观察两组的临床疗效,比较两组的血液流变学、血管内皮功能指标、美国国立卫生研究院卒中量表(NIHSS)评分。结果治疗后,对照组和治疗组的总有效率分别为80.43%、93.48%,两组比较差异有统计学意义(P0.05)。治疗后,两组全血黏度、血浆黏度、D-二聚体、纤维蛋白原水平均明显降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗后,治疗组的全血黏度、血浆黏度、D-二聚体、纤维蛋白原水平明显低于对照组,两组差异有统计学意义(P0.05)。治疗后,两组一氧化氮(NO)水平明显升高,内皮素-1(ET-1)、血栓素A2(TXA2)水平均明显降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗后,治疗组的NO水平高于对照组,ET-1、TXA2水平低于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组NIHSS评分显著降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗后,治疗组的NIHSS评分低于对照组,两组差异有统计学意义(P0.05)。结论养血清脑颗粒联合丁苯酞软胶囊治疗轻中度脑梗死具有较好的临床疗效,可改善血液流变学和血管内皮功能,有助于降低神经功能缺损程度,具有一定的临床推广应用价值。  相似文献   

5.
目的:探讨依达拉奉、氯吡格雷治疗急性脑梗死(acutecerebralinfarction,ACI)患者的临床疗效。方法93例急性脑梗死患者分为治疗组48例与对照组45例,两组均给予常规治疗,对照组在此基础上加用依达拉奉治疗,治疗组在对照组的基础上加用氯吡格雷。比较两组临床疗效,治疗前、后Barthel指数评分,NIHSS评分及ADL评分变化情况。结果(1)对照组与治疗组临床总体疗效分别为93.8%(45/48),75.6%(34/45),两组比较差异有统计学意义(P<0.05)。(2)两组治疗后与同组治疗前比较,Barthel指数、NIHSS及ADL评分均显著升高,在统计学比较(P<0.05);两组治疗后比较,Barthel指数、NIHSS及ADL评分治疗组均显著高于对照组,差异有统计学意义(P<0.05)。结论依达拉奉与氯吡格雷联合治疗急性脑梗死可以有效提高临床总有效率,改善患者症状及临床指征,两药联用治疗急性脑梗死具有协同作用,值得推广应用。  相似文献   

6.
目的探究阿加曲班联合氯吡格雷治疗急性后循环缺血性脑梗死的临床疗效。方法选取2015年1月—2017年1月河北省沧州中西医结合医院神经内科收治的急性后循环缺血性脑梗死患者100例,随机分为对照组和治疗组,每组各50例。对照组口服硫酸氢氯吡格雷片,1片/次,1次/d。治疗组在对照组治疗基础上给予阿加曲班注射液,60 mg/d,24 h持续静脉滴注,连续治疗2 d,第三天将剂量改为10 mg/次,2次/d,持续5 d。两组均连续治疗14 d。观察两组的临床疗效,比较两组NIHSS评分、BI指数、m RS评分。结果治疗后,对照组和治疗组的总有效率分别为88.0%、94.0%,两组比较差异有统计学意义(P0.05)。治疗7、14 d,两组患者NIHSS评分均显著降低,BI指数显著升高,同组治疗前后比较差异有统计学意义(P0.05);治疗7、14 d,治疗组NIHSS评分低于对照组,BI指数高于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组m RS评分显著低于对照组,两组比较差异具有统计学意义(P0.05)。结论阿加曲班联合氯吡格雷治疗急性后循环缺血性脑梗死具有较好的临床疗效,可降低NIHSS评分和m RS评分,具有一定的临床推广应用价值。  相似文献   

7.
《中国医药科学》2016,(16):156-159
目的探讨阿司匹林联合氯吡格雷治疗大脑中动脉狭窄脑梗死的临床效果。方法大脑中动脉狭窄脑梗死患者168例,随机分两组,对照组84例采用阿司匹林治疗,观察组84例采用阿司匹林联合氯吡格雷治疗,于治疗前后行Barthel指数、Fugl-Meyer评分、NIHSS评分、VAS评分,并检测血流动力学指标(全血低切黏度、全血高切黏度、血浆黏稠度、纤维蛋白原),比较两组临床疗效、预后。结果治疗后,两组Barthel指数、Fugl-Meyer评分增加(P0.05)。两组NIHSS评分、VAS评分、血流动力学指标(全血低切黏度、全血高切黏度、血浆黏稠度、纤维蛋白原)降低(P0.05)。观察组Barthel指数、Fugl-Meyer评分、治疗总有效率高于对照组(P0.05)。观察组NIHSS评分、VAS评分、血流动力学指标(全血低切黏度、全血高切黏度、血浆黏稠度、纤维蛋白原)、并发症发生率、疾病进展率、疾病复发率低于对照组(P0.05)。结论阿司匹林联合氯吡格雷治疗大脑中动脉狭窄脑梗死的疗效显著。患者临床指标、神经功能改善明显,预后较好。  相似文献   

8.
目的:探讨阿司匹林联合氯吡格雷治疗脑梗死的临床疗效。方法选取本院收治的56例脑梗死患者,随机均分为对照组和观察组,对照组患者给予氯吡格雷治疗,观察组患者给予阿司匹林联合氯吡格雷治疗,使用NIHSS评分评定神经功能,使用Barthel(BI)指数法评定日常生活活动能力。比较两组患者治疗前后NIHSS评分、BI指数和治疗总有效率的差异。结果两组患者治疗前NIHSS评分和BI指数比较差异无统计学意义(P〉0.05),治疗后两组评分均明显优于治疗前(P〈0.05),观察组NIHSS评分和BI指数均显著优于对照组(P〈0.05)。观察组治疗总有效率为89.3%,显著高于对照组的71.4%(P〈0.05)。结论阿司匹林联合氯吡格雷治疗脑梗死疗效确切,可有效改善血液流变学参数,显著减轻脑梗死症状,值得临床广泛推广使用。  相似文献   

9.
目的探讨丁苯酞软胶囊联合注射用单唾液酸四己糖神经节苷脂钠治疗急性分水岭脑梗死的临床疗效。方法选取2016年1月—2017年10月郑州市第九人民医院收治的急性分水岭脑梗死患者76例作为研究对象,根据随机数字表法将所有患者分为对照组和治疗组,每组各38例。对照组静脉滴注注射用单唾液酸四己糖神经节苷脂钠,100 mg加入到0.9%氯化钠注射液250 m L中,1次/d。治疗组在对照组治疗的基础上口服丁苯酞软胶囊,0.2 g/次,3次/d。两组患者均连续治疗2周。观察两组的临床疗效,比较两组的美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数(BI)评分、促血栓形成因子和血液流变学指标。结果治疗后,对照组和治疗组的总有效率分别为71.05%、89.47%,两组比较差异有统计学意义(P0.05)。治疗后,两组NIHSS评分显著降低,BI评分明显升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组NIHSS评分和BI评分明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组抗凝血酶Ⅲ(ATⅢ)水平明显升高,血小板聚集率(PAG)、纤维蛋白原(FIB)、D-二聚体(DD)水平明显降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组促血栓形成因子水平明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血浆黏度(PV)、全血高切黏度(HBV)、全血低切黏度(LBV)、红细胞聚集指数(Arbc)水平显著降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组血液流变学指标水平明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论丁苯酞软胶囊联合注射用单唾液酸四己糖神经节苷脂钠治疗急性分水岭脑梗死具有较好的临床疗效,可调节促血栓形成因子和血液流变学指标,改善神经功能,提升日常生活能力,具有一定的临床推广应用价值。  相似文献   

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《中国药房》2017,(30):4209-4212
目的:探讨阿司匹林联合氯吡格雷对大脑中动脉狭窄致脑梗死稳定期患者相关指标的影响。方法:回顾性分析127例大脑中动脉狭窄致脑梗死稳定期患者的病历资料,依据治疗药物不同分为观察组(65例)和对照组(62例)。两组患者均给予常规基础治疗,在此基础上对照组患者给予阿司匹林肠溶片200 mg,口服,每天1次;观察组患者在对照组治疗基础上加用硫酸氢氯吡格雷片75 mg,口服,每天1次。两组均连续治疗1年。观察并比较两组患者治疗前后凝血功能相关指标[D-二聚体(D-D)、血小板(PLT)计数、花生四烯酸(AA)诱导的PLT抑制率、二磷酸腺苷(ADP)诱导的PLT抑制率]、日常生活质量评分[改良的Fugl-Meyer评分、Barthel指数、美国国立卫生研究院卒中量表(NIHSS)评分]以及1年累积脑梗死复发情况和不良反应发生情况。结果:治疗前,两组患者上述各项指标比较,差异均无统计学意义(P>0.05)。治疗后,两组患者D-D水平、NIHSS评分均显著低于同组治疗前,且观察组显著低于对照组;AA诱导的PLT抑制率、ADP诱导的PLT抑制率、改良的Fugl-Meyer评分和Barthel指数均显著高于同组治疗前,且观察组显著高于对照组,差异均有统计学意义(P<0.05)。观察组患者1年累积脑梗死复发率显著低于对照组,差异有统计学意义(9.23%vs.22.58%,P<0.05)。两组患者治疗期间均未见严重不良反应发生。结论:与阿司匹林单用相比,阿司匹林联合氯吡格雷用于大脑中动脉狭窄致脑梗死稳定期患者可以显著改善其凝血功能,提高日常生活质量,降低脑梗死复发率,且安全性相当。  相似文献   

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Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.
Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.
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This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.  相似文献   

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Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.  相似文献   

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In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.  相似文献   

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Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.  相似文献   

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The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.  相似文献   

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