丹参多酚酸治疗非小细胞肺癌合并急性脑梗死临床观察

目的肺癌在我国发病率越来越高,但关于非小细胞肺癌合并急性脑梗死的研究较少,本研究观察丹参多酚酸对非小细胞肺癌合并急性脑梗死患者的治疗效果。方法回顾性分析2016-01-01-2018-05-31河北医科大学第四医院神经内科住院治疗的非小细胞肺癌合并急性脑梗死患者61例,依据2014年中国急性缺血性脑卒中诊治指南,均给予抗血小板聚集、抗自由基、稳定动脉斑块及营养脑细胞治疗。其中,31例在上述治疗基础上,给予丹参多酚酸治疗(治疗组),30例患者给予基础治疗(对照组)。比较2组患者一般资料、治疗前后的D-二聚体、血浆纤维蛋白原(Fibrinogen,Fib)、美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分和改良的Rankin量表(modified Rankin scale,mRS)。结果治疗组和对照组一般资料比较,差异均无统计学意义;治疗前2组D-二聚体、Fib、NIHSS评分和mRS评分差异均无统计学意义。治疗后,治疗组和对照组D-二聚体分别为(1.73±0.13)和(2.42±0.24)mg/L,差异有统计学意义,Z=-1.99,P=0.046;Fib分别为(6.69±0.47)和(8.94±0.49)mg/L,差异有统计学意义,Z=-2.76,P=0.006;NIHSS评分分别为2.68±0.21和3.38±0.27,差异有统计学意义,Z=-3.145,P=0.002;2组mRS评分均较治疗前改善(χ^2=-2.074,P=0.038),治疗组较对照组明显,治疗后2组之间的差异有统计学意义,P<0.05。结论注射用丹参多酚酸可以改善非小细胞肺癌合并脑梗死患者的高凝状态,提高患者的神经功能评分,改善预后及生活质量。

Efficacy of salvianolic acid in the treatment of acute cerebral infarction patients with non-small cell lung cancer

OBJECTIVE The incidence of lung cancer is getting higher and higher in our country,but there are few studies on the treatment of acute cerebral infarction patients with non-small cell lung cancer.This research was to study the efficacy of salvianolic acid in the treatment of acute cerebral infarction patients with non-small cell lung cancer.METHODS Totally 61 acute cerebral infarction patients with non-small cell lung cancer treated in the Department of Neurology,Fourth Hospital of Hebei Medical University from January 1,2016 to May 31,2018 were collected retrospectively.All the patients’treatments were based on the Chinese guidelines for the diagnosis and treatment of acute ischemic stroke in 2014,include anti-platelet aggregation,anti-free radical,stabilizing arteriosclerotic plaques and recovering brain cells medicines.Totally 31 cases were treated with salvianolic acid as experimental group,and the rest 30 cases were treated as control group.Clinical data such as general data,D-dimer,fibrinogen,NIHSS score andmRS score were collected before and after treatment.RESULTS There was no statistical difference in general data between the experimental group and the control group.There was no significant difference in D-dimer,Fib,NIHSS score and mRS score between the two groups before treatment.After treatment,the D-dimer between the experimental group and the control group were(1.73±0.13)and(2.42±0.24)mg/L respectively,with significant difference,Z=-1.99,P=0.046.Fib between the experimental group and the control group after treatment were(6.69±0.47)and(8.94±0.49)mg/L,respectively,with significant difference,Z=-2.76,P=0.006.The NIHSS scores between the experimental group and the control group were(2.68±0.21)and(3.38±0.27).There was significant difference between the two groups,Z=-3.145,P=0.002.The mRS scores between both groups were improved compared with those before treatment,χ^2=-2.074,P=0.038.The improvement of the experimental group was significantly higher than that of the control group significantly,P<0.05.CONCLUSION Salvianolic acid injection can reduce the hypercoagulable state of acute cerebral infarction patients with non-small cell lung cancer and is helpful for the recovery of neurological function.