丹参川芎嗪注射液联合阿加曲班治疗急性脑梗死的临床研究

目的探讨丹参川芎嗪注射液联合阿加曲班治疗急性脑梗死的临床疗效。方法选取2014年5月—2017年5月在天津市北辰医院治疗的急性脑梗死患者74例,根据用药的差别分为对照组(37例)和治疗组(37例)。对照组静脉滴注阿加曲班注射液,30 mg加入5%葡萄糖溶液250 m L,持续24 h,治疗2 d后20 mg加入5%葡萄糖溶液250 m L,2次/d。治疗组在对照组的基础上静脉滴注丹参川芎嗪注射液,10 m L加入5%葡萄糖溶液250 m L,1次/d。两组均治疗两周。观察两组患者临床疗效,比较治疗前后两组患者国立卫生研究院卒中量表(NIHSS)、BI指数、m RS评分、血清学指标和血液流变学指标。结果治疗后,对照组和治疗组临床有效率分别为81.08%和94.59%,两组比较差异具有统计学意义(P0.05)。治疗后,两组NIHSS评分和m RS评分明显降低,BI指数评分明显升高,同组比较差异具有统计学意义(P0.05);且治疗组上述评分改善后水平明显优于对照组(P0.05)。治疗后,两组血清肽素(CPP)、亲环素A(Cy PA)、心脏型脂肪酸结合蛋白(H-FABP)水平显著降低,胰岛素样生长因子1(IGF-1)和脑源性神经营养因子(BDNF)显著增加,同组比较差异具有统计学意义(P0.05);且治疗组血清学指标明显优于对照组(P0.05)。治疗后,两组红细胞压积(HCT)、全血粘度(WBV)、纤维蛋白原(FIB)和血浆黏度(PV)水平均明显降低(P0.05);且治疗组上述血液流变学指标显著低于对照组(P0.05)。结论丹参川芎嗪注射液联合阿加曲班治疗急性脑梗死可有效改善机体血液流变学指标,降低机体炎症反应、促进神经功能恢复和改善日常活动能力。

Clinical study on Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection combined with argatroban in treatment of acute cerebral infarction

Objective To explore the clinical efficacy of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection combined with argatroban in treatment of acute cerebral infarction. Methods Patients (74 cases) with acute cerebral infarction in Tianjin Beichen Hospital from May 2014 to May 2017 were divided into control (37 cases) and treatment (37 cases) based on different treatment. Patients in the control group were iv administered with Argatroban Injection, 30 mg added into 5% glucose solution 250 mL for 24 h, then 20 mg added into 5% glucose solution 250 mL after treated for 2 d, twice daily. Patients in the treatment group were iv administered with Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection on the basis of the control group, 10 mg added into 5% glucose solution 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, the NIHSS, BI indexes and mRS scores, the serological indexes and hemorheological indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 81.08% and 94.59% respectively, and there were differences between two groups (P < 0.05). After treatment, the NIHSS and mRS scores in two groups were significantly decreased, BI indexes scores was significantly increased, and there were differences in the same group (P < 0.05). And these scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the CPP, CyPA and H-FABP levels in two groups were significantly decreased, IGF-1 and BDNF levels were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And these serological indexes levels in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the HCT, WBV, FIB and PV levels in two groups were significantly decreased (P < 0.05). And the hemorheological indexes levels in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection combined with argatroban in treatment of acute cerebral infarction can effectively improve hemorheological indexes, reduce inflammation, promote the recovery of neurological function and improve the ability of daily activities.