依达拉奉治疗急性大面积脑梗死临床分析

目的观察依达拉奉治疗急性大面积脑梗死的疗效与安全性。方法急性大面积脑梗死患者144例，完全随机分为依达拉奉组和对照组，各72例。2组患者入院后均给予脑梗死常规治疗，依达拉奉组再给予依达拉奉30mg加入生理盐水100ml静脉滴注，30min内滴完，2次／d，连用14d。治疗后对2组患者神经功能缺损程度评分（NDS）、血浆纤维蛋白原（Fib）、PT、APTF、凝血酶时间（1Tr）、国际标准化比率（INR）及超氧化物歧化酶（SOD）、丙二醛水平进行检测。结果依达拉奉组和对照组治疗后NDS比治疗前均有明显降低（5．3±4．7）分比（15．6±7．9）分、（8．74-5．6）分比（17．2±8．5）分，均P〈0．05]。2组治疗前后血浆Fib含量、PT、APq＂Y、1-r、INR检测，差异均无统计学意义（均P〉0．05）。依达拉奉组的显效率明显高于对照组87．5％（63／72）比45．8％（33／72），P〈0．05]。对照组治疗后血清SOD水平明显低于治疗前（136±18）U／m1比（149．4-25）U／ml，P〈0．05]，依达拉奉组治疗后血清SOD水平高于治疗前（157±26）U／ml比（150±22）U／ml，P〈0．05]；治疗后依达拉奉组血清SOD水平明显高于对照组（P〈0．01）。对照组治疗后血清丙二醛水平高于治疗前（6．1±2．3）μmol／L比（5．6±2．0）μmol／L，P〈0．01]，依达拉奉组治疗后血清丙二醛水平低于治疗前（4．1±1．3）μmo]／L比（5．5±2．0）μmol／L，P〈0．01]，治疗后依达拉奉组血清丙二醛水平明显低于对照组（P〈0．01）。依达拉奉组中出现轻度转氨酶升高2例，尿素氮升高2例，经相应治疗，短期内均恢复正常。结论依达拉奉治疗急性大面积脑梗死的疗效较好，可清除急性大面积脑梗死患者体内过多的丙二醛，对SOD有明显的保护作用，无明显不良反应。

Analysis of curative effects and security of edaravone treating acute massive cerebral infarction

Objective To observe the curative effects and security of edaravone in treatment of acute massive cerebral infarction. Methods One hundred and forty-four patients with acute massive cerebral infarction were randomized into edaravone group （72 patients） and control group （72 patients）. Two groups had conventional treatment for cerebral infarction. Edaravone group had edaravone 30 rag, twice a day for 14 days. Neuralgic function deficit score （ NDS ） , plasma fibrinogen （Fib） content and coagulation blood function were examined before and after the treatment. Superoxide dismutase and malondialdehyde level were measured before and after treatment. The clinical efficacy was compared between the two groups. Results NDS of two groups after treatment were significantly lower than that before treatment. The degree of edaravone group improvement was obviously higher than that in the control group （ all P 〈 0.05 ）. Plasma Fib contents and coagulation blood function in the two groups before and after treatment showed no statistically difference （ all P 〉 0.05 ）. Significant efficiency ratio of the edaravone group 87.5% （63/72）] was significantly higher than that of the control group 45.8% （33/72）] （P 〈 0.05 ）. Serum superoxide dismutase （SOD） level was significantly higher after treatment in control group （136 ± 18 ）U/ml vs （7149 ± 25 ）U/ml, P 〈 0.05 ] , and in the edaravone group serum SOD level was higher after treatment （157±26）U/ml vs （150 ±22）U/m1, P 〈0.05]. Serum SOD level before treatment had no significant difference between the two groups （P 〉 0.05 ） , while serum SOD level of edaravone group was significantly higher than that of control group after treatment （P 〈 0.01 ）. Serum NDS level in control group was higher after treatment （ 6.1 ± 2.3 ）μ mol/L vs （5.6 ± 2.0 ） μmol/L, P 〈 0.01 ] , and in the edaravone group serum NDS level was lower （4.1± 1.3）μmol/L vs （5.5 ±2.0）μmol/L, P 〈0.01]. Serum NDS levels before treatment showed no significancce between the two groups （ P 〉 0.05 ）, while serum NDS level in edaravone group was significantly lower than that in the control group （P 〈 0.01 ）. In the edaravone group, there were 2 cases of mildly elevated liver transaminases and 2 cases of elevated blood urea nitrogen. After treatment, these cases were back to normal. Conclusions Edaravone treating acute massive cerebral infarction is effective and safe. Edaravone can clear excessive NDS in patients of acute cerebral infarction and protect SOD significantly.