高压氧联合法舒地尔治疗32例青壮年脑梗塞的疗效评价

目的：研究高压氧联合法舒地尔对青壮年脑梗塞患者的疗效及对血清细胞因子水平的影响。方法：回顾性分析60例青壮年脑梗塞患者，根据治疗方式分为对照组28例和观察组32例。对照组给予脱水降压、抗血小板凝聚、脑细胞保护剂及对症支持等常规治疗，而观察组在对照组的基础上采用高压氧联合盐酸法舒地尔治疗，比较2组患者临床疗效及治疗前后的日常生活活动能力（ADL评分）和血清TNF-a、IL-6和CRP浓度的变化。结果：观察组大动脉粥样硬化型和穿支动脉疾病型脑梗塞的治疗总有效率显著高于对照组的（P＜0.05）；观察组心源性卒中型和其他类型青壮年脑梗塞的治疗总有效率高于对照组的，但差异无统计学意义（P>0.05）；观察组治疗后的ADL评分显著高于对照组、而7 d、14 d血清TNF-α、IL-6和CRP的水平均显著低于对照组（P＜0.05）。结论：高压氧联合法舒地尔治疗青壮年脑梗塞效果确切，并能调节血清中TNF-α、IL-6和CRP的水平，不良反应少，值得临床进一步实践。

Efifcacy of fasudil hydrochloride combined with hyperbaric oxygenation in the treatment of 32 cases of the young and middle-aged patients with cerebral infarction

Objective:To discuss the efficacy of fasudil hydrochloride combined with hyperbaric oxygenation in the treatment of the young and middle-aged patients with cerebral infarction and their effects on serum cytokine levels. Methods:Sixty cases of patients with cerebral infarction in young and middle-aged adult were retrospectively analyzed and divided into a control group with 28 cases and an observation group with 32 cases based on their different treatment methods. The control group was treated with conventional therapies such as depressurizing by dehydration, anti-platelet aggregation, brain cell protective agent and symptomatic treatment while the observation group was additionally treated with fasudil hydrochloride combined with hyperbaric oxygenation besides the conventional therapies. The total effective rate, the activities of daily living (ADL) and the changes of TNF-a、IL-6 and CRP levels were compared between two groups. Results:The total effective rates in cerebral infarction patients with large-artery atherosclerosis and perforating artery infarction were significantly higher in the observation group than in the control group (P<0.05). The total effective rate in patients with cardioembolic stroke and other types was higher in the observation group than in the control group, but the differences showed no statistical significance (P>0.05). The score of ADL after 30 d treatment was signiifcantly higher while the levels of TNF-α、IL-6 and CRP after 7 d、14 d treatment were signiifcantly lower in the observation group than in the control group (P<0.05). Conclusion:The efifcacy of hyperbaric oxygenation combined with fasudil hydrochloride in the treatment of young and middle-aged patients with cerebral infarction is evident and they can regulate the levels of serum TNF-α、IL-6 and CRP with less adverse reaction and are worthy of further clinical practice.