藻酸双酯钠对急性脑梗死患者血浆P-选择素的影响作用研究

目的 探讨藻酸双酯钠（PSS）对急性脑梗死患者血小板活化作用的影响。方法 急性脑梗死患者76例，随机分为两组：治疗组38例，每日静脉点滴PSS150mg；对照组38例，每日静脉点滴维脑路通600mg，均连续用药14d。于治疗前、治疗后第7天、第14天检测两组患者血浆P-选择素含量，并比较两组欧洲卒中量表（ESS）评分的差异。结果 两组患者血浆P-选择索治疗前比较，差异元统计学意义（P〉0．05）；治疗后第7天、第14天时治疗组P-选择索明显低于对照组（P〈0．01），且两组治疗第14天时均低于治疗前（P〈0．05或〈0．01）。结论 PSS可通过降低血浆P-选择素水平而发挥抗凝、抗血小板活化作用，对急性脑梗死有较好的治疗作用。

Effect of polysaccharide sulfate on plasmatic P - selectln in patient with acute cerebral infarction

Objective To determine the occurrence of rhabdomyolysis(RM) in the diabetic hyperosmolar hyperglycemic state.Methods Sixteen patients(9 men and 7 women) with diabetic hyperosmolar state were studied.Six of 16(37.50%) patients showed biochemical evidence of RM.The clinical and biochemical features of the patients with RM(group RM) and the patients without RM(group non-RM) were compared.Results Patients with RM showed a 30-fold increase in serum creatine phospholipase(CK) and 50-fold in myoglobin (Mb) when compared to the patients without RM.Significantly higher mean glucose level,serum sodium level and serum osmolality were found in patients with RM than in those without RM(P<0.05).On the other hand,the mean serum potassium and phosphorus levels were lower in group RM than in group non-RM(P<0.05).Although no deference was found in the occurrence of acute renal failure between group RM and group non RM(100.00% vs 60.00%,P=(0.0736)),but the difference of mean BUN and Cr levels was significant between the two groups(P<0.05).None of patients with RM was found the occurrence of RM during hospital.Conclusion Subclinical RM is not uncommon found in the hyperosmolar state,but often unrecognized.It is recommend that any patient with diabetic hyperosmolar hyperglycemic state should have muscles enzymes,especially CK,monitored routinely at least for the first a few days after admission.