[1]钱时德,赵　全,焦冬生,等.依达拉奉联合重组组织型纤溶酶原激活剂静脉溶栓治疗急性脑梗死疗效观察[J].新乡医学院学报,2020,37(11):1040-1043.[doi:10.7683/xxyxyxb.2020.11.008]
　QIAN Shide,ZHAO Quan,JIAO Dongsheng,et al.Effect of edaravone combined with recombinant tissue type plasminogen activator intravenous thrombolysis in the treatment of acute cerebral infarction[J].Journal of Xinxiang Medical University,2020,37(11):1040-1043.[doi:10.7683/xxyxyxb.2020.11.008]
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依达拉奉联合重组组织型纤溶酶原激活剂静脉溶栓治疗急性脑梗死疗效观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年11
页码:
1040-1043
栏目:
临床研究
出版日期:
2020-11-05

文章信息/Info

Title:
Effect of edaravone combined with recombinant tissue type plasminogen activator intravenous thrombolysis in the treatment of acute cerebral infarction
作者:
钱时德; 赵　全; 焦冬生; 胡子奇; 李惠俊; 王燕燕
（中国人民解放军东部战区空军医院神经内科，江苏　南京　210002）
Author(s):
QIAN Shide; ZHAO Quan; JIAO Dongsheng; HU Ziqi; LI Huijun; WANG Yanyan
(Department of Neurology,China People′s Liberation Army Eastern Theater Air Force Hospital,Nanjing 210002,Jiangsu Province,China)
关键词:
急性脑梗死; 依达拉奉; 重组组织型纤溶酶原激活剂; 溶栓疗法
Keywords:
acute cerebral infarction; edaravone; recombinant tissue type plasminogen activator; thrombolytic therapy
分类号:
R743.3
DOI:
10.7683/xxyxyxb.2020.11.008
文献标志码:
A
摘要:
目的　探讨依达拉奉联合重组组织型纤溶酶原激活剂（rt-PA）治疗急性脑梗死的临床效果。方法　选择2016年9月至2019年5月中国人民解放军东部战区空军医院收治的70例急性脑梗死患者为研究对象，根据治疗方法将患者分为观察组（n=37）和对照组（n=33），2组患者均给予rt-PA 0.9 mg·kg-1（最大剂量为90 mg），静脉滴注，1 min内给予静脉注射10％的剂量，其余剂量在60 min内持续静脉滴注完毕；在此基础上，观察组患者给予依达拉奉30 mg，30 min内静脉滴注完毕，每日2次，连续给药14 d。于治疗前和治疗后14 d，采用美国国立卫生研究院卒中量表（NIHSS）评估2组患者神经功能缺损情况，采用Fugl-Meyer量表评估患者肢体运动功能，采用脑卒中专用生活质量量表（SS-QOL）评估患者的生活质量，采用比色法检测血清丙二醛（MDA）和超氧化物歧化酶（SOD）水平；治疗期间观察2组患者不良反应发生情况，治疗后14 d评估患者临床疗效。结果　治疗前2组患者NIHSS评分比较差异无统计学意义（P>0.05），2组患者治疗后NIHSS评分显著低于治疗前（P<0.05）；治疗后，观察组患者NIHSS评分显著低于对照组（P<0.05）。治疗前2组患者Fugl-Meyer评分、SS-QOL评分比较差异无统计学意义（P>0.05），2组患者治疗后Fugl-Meyer评分、SS-QOL评分显著高于治疗前（P<0.05）；治疗后，观察组患者Fugl-Meyer评分、SS-QOL评分显著高于对照组（P<0.05）。治疗前2组患者血清SOD、MDA水平比较差异无统计学意义（P>0.05）；2组患者治疗后血清SOD水平显著高于治疗前，MDA水平显著低于治疗前（P<0.05）；治疗后，观察组患者血清SOD水平显著高于对照组，MDA水平显著低于对照组（P<0.05）。观察组和对照组患者总有效率分别为94.59%（35/37）、72.73%（24/33），观察组患者总有效率显著高于对照组（χ2=6.207，P<0.05）。观察组和对照组患者不良反应发生率分别为8.11%（3/37）、27.27%（9/33），观察组患者不良反应发生率显著低于对照组（χ2=4.446，P<0.05）。观察组和对照组患者出血性转化发生率分别为2.70%（1/37）、21.21%（7/33），观察组患者出血性转化发生率显著低于对照组（χ2=4.217，P<0.05）。结论　依达拉奉联合rt-PA治疗急性脑梗死患者疗效确切，可显著改善患者神经功能，降低溶栓治疗出血性风险，提高患者生活质量。
Abstract:
Objective　To investigate the clinical effect of edaravone combined with recombinant tissue type plasminogen activator (rt-PA) in the treatment of acute cerebral infarction.Methods　A total of 70 patients with acute cerebral infarction admitted to the China People’s Liberation Army Eastern Theater Air Force Hospital from September 2016 to May 2019 were selected as the research subjects,and the patients were divided into observation group (n=37) and control group (n=33) according to the treatment methods.The patients in the two groups were treated with rt-PA 0.9 mg·kg-1 (the maximum dose was 90 mg) by intravenous drip,the 10% of rt-PA was given within 1 min,and the rest of rt-PA was continuously intravenous drip within 60 min.On this basis,the patients in the observation group were treated with edaravone 30 mg by intravenous drip within 30 minutes,twice a day for 14 d.Before and 14 d after treatment,the neurologic impairment of patients was evaluated by United States National Institutes of Health stroke scale (NIHSS),the limb motor function of the patients was assessed by Fugl-Meyer scale,the quality of life of the patients was assessed by the stroke-specific quality of life (SS-QOL),and the levels of serum malondialdehyde (MDA) and superoxide dismutase (SOD) were measured by colorimetry.The incidence of adverse reactions was observed during the treatment,and the clinical efficacy was evaluated at 14 d after treatment.Results　There was no significant difference in NIHSS score between the two groups before treatment (P>0.05),the NIHSS score after treatment was significantly lower than that before treatment in the two groups (P<0.05),and the NIHSS score in the observation group was significantly lower than that in the control group after treatment (P<0.05).There was no significant difference in Fugl-Meyer score and SS-QOL score between the two groups before treatment (P>0.05),the Fugl-Meyer score and SS-QOL score after treatment were significantly higher than those before treatment in the two groups (P<0.05),and the Fugl-Meyer score and SS-QOL score in the observation group were significantly higher than those in the control group after treatment (P<0.05).There was no significant difference in serum SOD and MDA levels between the two groups before treatment (P>0.05).After treatment,the serum SOD level was significantly higher than that before treatment,and the MDA level was significantly lower than that before treatment in the two groups (P<0.05).After treatment,the serum SOD level in the observation group was significantly higher than that in the control group,and the serum MDA level in the observation group was significantly lower than that in the control group (P<0.05).The total effective rate in the observation group and the control group was 94.59% (35/37) and 72.73% (24/33),respectively.The total effective rate in the observation group was significantly higher than that in the control group (χ2=6.207,P<0.05).The incidence of adverse reactions in the observation group and the control group was 8.11% (3/37) and 27.27% (9/33),respectively.The incidence of adverse reactions in the observation group was significantly lower than that in the control group (χ2=4.446,P<0.05).The incidence of hemorrhagic transformation in the observation group and the control group was 2.70% (1/37) and 21.21% (7/33),respectively.The incidence of hemorrhagic transformation in the observation group was significantly lower than that in the control group (χ2=4.217,P<0.05).Conclusion　Edaravone combined with rt-PA is effective in the treatment of acute cerebral infarction.It can significantly improve the neurological function of patients,reduce the risk of bleeding in thrombolytic therapy,and improve the quality of life of patients.

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更新日期/Last Update: 2020-11-05