前列地尔治疗急性大脑中动脉闭塞性脑梗死患者疗效的对比观察

目的 观察前列地尔治疗急性大脑中动脉闭塞性脑梗死患者的临床疗效.方法 将112例经脑血管造影证实为大脑中动脉闭塞性所致的急性脑梗死患者随机分为两组,对照组55例,采用常规治疗;治疗组57例,在常规治疗基础上加用前列地尔脂微球载体制剂10μg,静脉点滴,1次/d,14d为一疗程.评价治疗前后神经功能缺损评分的变化及疗效,监测用药前后脑出血等并发症的发生情况及凝血功能、肝肾功能的变化.结果 治疗组治疗后14d、28d NIHSS评分较对照组明显减少,差异有统计学意义（P〈0.05）;两组治疗后BI评分均较治疗前增加（P〈0.05）,治疗组治疗后BI评分增加较对照组差异有统计学意义（P〈0.05）;两组治疗后ADL评分均减少（P〈0.05）,治疗组治疗后ADL评分减少较对照组差异有统计学意义（P〈0.05）;两组不良事件发生情况无明显差异.结论 大脑中动脉闭塞所致的急性脑梗死患者病情较重,治疗效果差;前列地尔脂微球载体制剂治疗颅内动脉狭窄所致的急性脑梗死患者安全有效.

The effect of alprostadil on acute cerebral infarction caused by middle cerebral artery arterial occlusion

Objective To study the effect of alprostadil on acute cerebral int：arction caused by iniddie cerebral artery arterial occlusion. Methods 112 cases those confirmed as acute cerebral infarction caused by middle cerebral artery occlusion through cerebral angiography, were divided into two groups randomly. Patients （n = 55） in control group were treated with conventional therapy, and the other 57 cases in treatment group received alprostadil treatment （lOp.g, iv, qd, 14d for a course） besides conventional treatment. Evaluated the changes of neurological function and efficacy, monitored the complications such as cerebral hemorrhage incidence and the coagulation, liver and kidney function changes before and after the treatment. Results 14 days and 28 days after treatment, the NIHSS assessment of the treatment group was siguificantly reduced compared with control group （ P 〈 0. 05 ） ; BI scores of both two groups were increased （ P 〈 0. 05 ）, but the treatment group increased more significantly （P 〈 0. 05 ） ; ADL scores of the two groups were reduced after treatment （ P 〈 0. 05 ）, but treatment group decreased more significantly （P 〈 0. 05 ） ; the occurrence of adverse events of the two groups had no significant difference. Conclusions Patients with acute cerebral infarction, caused by middle cerebral artery occlusion, got severe illness and the effect of current treatment for them was not as well as expected. Alprostadil lipo-preparations proved to be safe and effective on the treatment of acute cerebral infarction caused by intraeranial arterial stenosis.