羟乙基淀粉联合扩血管药物对急性脑梗死患者的疗效及安全性研究

目的:研究羟乙基淀粉联合扩血管药物对急性脑梗死患者的疗效及安全性。方法:选取某院2015年1月1日-2018年12月31日诊断为急性脑梗死的患者,符合入、排标准的患者共390例,分为2组,每组195例。羟乙基淀粉组:常规治疗基础上给予羟乙基淀粉扩容治疗;羟乙基淀粉联合扩血管组:常规治疗基础上给予羟乙基淀粉联合1种或2种扩血管药物治疗。比较治疗前后2组患者NIHSS评分、MRS评分变化;脑水肿和肾功能异常发生率以及死亡率。结果:从2组治疗前后的NIHSS评分和MRS评分的变化水平来看,羟乙基淀粉联合扩血管药物较单用羟乙基淀粉并不能明显改善患者的上述两项评分(P>0.05)。在安全性方面,2组患者病死率无统计学差异(均为0.51%);但在脑水肿发生率及肾功能异常发生率上,羟乙基淀粉联合扩血管组(3.08%,2.05%)明显低于单用羟乙基淀粉组(7.69%,10.26%),2组差异具有统计学意义(P<0.05);在联合扩血管治疗组中,联合一种扩血管药物与联合2种扩血管药物在肾功能异常和脑水肿的发生率均无统计学差异(P>0.05)。结论:羟乙基淀粉联合扩血管药物较单用羟乙基淀粉治疗,并不能明显提高NIHSS评分和MRS评分,但可以在一定程度上降低脑水肿和肾功能异常的发生率,然而联合一种还是2种扩血管药没有明显差别。

Efficacy and safety of hydroxyethyl starch combined with vasodilator drug in patients with Acute cerebral infarction

OBJECTIVE To study the efficacy and safety of hydroxyethyl starch combined with vasodilator drugs in patients with acute cerebral infarction.METHODS A total of 390 patients diagnosed with acute cerebral infarction in our hospital from January 1,2015 to December 31,2018 were selected and divided into two groups,195 cases in each group:hydroxyethyl starch group:hydroxyethyl starch volume expansion therapy on the basis of conventional treatment;hydroxyethyl starch combined with vasodilator group:hydroxyethyl starch combined with one or two vasodilators therapy on the basis of conventional treatment.NIHSS score,MRS score,incidence of cerebral edema and abnormal renal function and mortality were compared between the two groups before and after treatment.RESULTS From the changes of NIHSS and MRS score before and after treatment,there was no significant improvement in hydroxyethyl starch combined with vasodilator group compared with hydroxyethyl starch group(P> 0.05).In terms of safety,there was no significant difference in mortality between the two groups(both 0.51%);however,in the incidence of cerebral edema and renal dysfunction,hydroxyethyl starch combined with vasodilator group(3.08%,2.05%)significantly lower than hydroxyethyl starch group(7.69%,10.26%);the difference between the two groups was statistically significant(P<0.05);in the combined vasodilator group,combined with one or two vasodilator drugs,there was no significant difference in the incidence of renal dysfunction and cerebral edema in two groups(P>0.05).CONCLUSION Compared with hydroxyethyl starch,hydroxyethyl starch combined with vasodilators can not significantly improve NIHSS score and MRS score,but can reduce the incidence of cerebral edema and abnormal renal function to a certain extent.However,there is no significant difference between the two combination regimes.