依达拉奉联合托拉塞米治疗急性脑出血患者的疗效

目的:研究依达拉奉联合托拉塞米治疗急性脑出血患者的疗效。方法:2016年1月至2018年4月我院的急性脑出血患者92例被随机均分为依达拉奉组(在常规治疗基础上接受依达拉奉)和联合治疗组(在依达拉奉组基础上加用托拉塞米),两组均治疗8周。观察比较两组治疗前后全血高切黏度(WBHSV)、全血中切黏度(WBMSV)、全血低切黏度(WBLSV)、红细胞沉降率(ESR)、血浆黏度(PV)、血浆凝血酶原时间(PPT)、活化部分凝血活酶时间(APTT)、血浆纤维蛋白原(Fg)水平、血清肿瘤坏死因子(TNF)-α、C反应蛋白(CRP)、白介素(IL)-2水平及治疗总有效率。结果:联合治疗组总有效率显著高于依达拉奉组(93.5%比78.3%,P=0.036)。与依达拉奉组比较,联合治疗组治疗后WBHSV [(5.45±0.19)mPa·s比(4.21±0.37)mPa·s]、WBMSV [(5.71±0.28)mPa·s比(4.23±0.54)mPa·s]、WBLSV [(9.32±0.39)mPa·s比(7.19±0.41)mPa·s]、ESR [(35.18±3.92)%比(28.19±2.87)%]、PV [(1.68±29)mPa·s比(1.17±0.31)mPa·s]、血浆Fg[(3.52±0.49)g/L比(3.18±0.47)g/L]水平、血清TNF-α[(2.24±0.41)μg/L比(1.89±0.52)μg/L]、CRP [(15.25±3.15)mg/L比(9.51±3.09)mg/L]水平降低更显著,PPT [(12.88±1.12)s比(13.42±1.35)s]、APTT[(34.88±0.74)s比(37.41±0.82)s]、血清IL-2[(9.97±1.78)ng/L比(10.82±1.47)ng/L]水平升高更显著,P<0.05或<0.01。结论:依达拉奉联合托拉塞米治疗急性脑出血患者的疗效显著,可显著改善患者微循环与凝血功能,降低体内炎症反应,值得临床推广应用。

Therapeutic effect of edaravone combined torasemide on patients with acute cerebral hemorrhage

Objective:To study therapeutic effect of edaravone combined torasemide on patients with acute cerebral hemorrhage.Methods:A total of 92 patients with acute cerebral hemorrhage in our hospital from Jan 2016 to Apr2018 were randomly and equally divided into edaravone group(received edaravone based on routine treatment)and combined treatment group(received torasemide based on edaravone group).Both groups were treated for eight weeks.Whole blood high shear viscosity(WBHSV),whole blood medium shear viscosity(WBMSV),whole blood low shear viscosity(WBLSV),erythrocyte sedimentation rate(ESR),plasma viscosity(PV),plasma prothrombin time(PPT),activated partial thromboplastin time(APTT),plasma levels of fibrinogen(Fg),serum levels of tumor necrosis factor(TNF)-α,C reactive protein(CRP)and interleukin(IL)-2 before and after treatment and total effective rate were observed and compared between two groups.Results:Total effective rate of combined treatment group was significantly higher than that of edaravone group(93.5% vs.78.3%,P=0.036).Compared with edaravone group after treatment,there were significant reductions in WBHSV [(5.45±0.19)mPa·s vs.(4.21±0.37)mPa·s],WBMSV [(5.71±0.28)mPa·s vs.(4.23±0.54)mPa·s],WBLSV [(9.32±0.39)mPa·s vs.(7.19±0.41)mPa·s],ESR [(35.18±3.92)% vs.(28.19±2.87)%],PV [(1.68±0.29)mPa·s vs.(1.17±0.31)mPa·s],plasma levels of Fg[(3.52±0.49)g/L vs.(3.18±0.47)g/L],serum levels of TNF-α[(2.24±0.41)μg/L vs.(1.89±0.52)μg/L]and CRP[(15.25±3.15)mg/L vs.(9.51±3.09)mg/L],and significant rise in PPT [(12.88±1.12)s vs.(13.42±.35)s],APTT [(34.88±0.74)s vs.(37.41±0.82)s]and serum IL-2 level[(9.97±1.78)ng/L vs.(10.82±1.47)ng/L]in combined treatment group(P<0.05 or <0.01).Conclusion:Edaravone combined torasemide possesses significant therapeutic effect on patients with acute cerebral hemorrhage.It can significantly improve microcirculation and blood coagulation function and reduce inflammation,which is worth extending.