[1]毛向莹,谭 静,高 磊,等.促红细胞生成素治疗老年脑梗死疗效观察[J].新乡医学院学报,2017,34(7):657-659.[doi:10.7683/xxyxyxb.2017.07.028]
 MAO Xiang-ying,TAN Jing,GAO Lei,et al.Effect of erythropoietin in the treatment of elderly patients with cerebral infarction[J].Journal of Xinxiang Medical University,2017,34(7):657-659.[doi:10.7683/xxyxyxb.2017.07.028]
点击复制

促红细胞生成素治疗老年脑梗死疗效观察
分享到:

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
34
期数:
2017年7
页码:
657-659
栏目:
临床研究
出版日期:
2017-07-05

文章信息/Info

Title:
Effect of erythropoietin in the treatment of elderly patients with cerebral infarction
作者:
毛向莹1谭 静2高 磊1谢 敏1
(1.长垣县人民医院神经内科,河南 长垣 453400;2.河南医学高等专科学校内科学教研室,河南 郑州 451191)
Author(s):
MAO Xiang-ying1TAN Jing2GAO Lei1XIE Min1
(1.Department of Neurology,the People′s Hospital of Changyuan County,Changyuan 453400,Henan Province,China;2.Department of Medicine,Henan Medical College,Zhengzhou 451191,Henan Province,China)
关键词:
促红细胞生成素脑梗死神经功能
Keywords:
erythropoietincerebral infarctionneurological function
分类号:
R743.33
DOI:
10.7683/xxyxyxb.2017.07.028
文献标志码:
A
摘要:
目的 探讨促红细胞生成素(EPO)治疗老年脑梗死患者的临床疗效及不良反应。方法 选择2015年6月至2016年12月长垣县人民医院神经内科收治的180 例老年脑梗死患者,分为治疗组和对照组,每组90 例。对照组患者进行常规治疗,治疗组患者在常规治疗基础上应用EPO治疗。观察2组患者的临床治疗效果及不良反应,评估治疗前后患者脑梗死面积、神经功能缺损程度(AS)及日常生活状况,同时检测患者治疗前后血清C反应蛋白(CRP)水平。结果 治疗组患者治疗总有效率(90.00%,81/90)显著高于对照组(77.78%,70/90)(χ2=4.57,P<0.05)。对照组、治疗组患者治疗前脑梗死面积分别为(8.96±0.35)、(9.01±0.23)cm2,治疗后分别为(5.47±0.12)、(4.03±0.48)cm2,2组患者治疗前脑梗死面积比较差异无统计学意义(P>0.05),治疗后2组患者脑梗死面积均较治疗前显著缩小,且治疗组患者脑梗死面积显著低于对照组(P<0.05)。2组患者治疗前AS、巴氏指数(BI)评分及血清CRP水平比较差异均无统计学意义(P>0.05);2组患者治疗后AS评分及血清CRP水平均较治疗前显著降低,BI评分较治疗前显著增加,且治疗组患者治疗后AS评分及血清CRP水平较对照组下降更显著,BI评分较对照组增加更显著(P<0.05)。对照组患者不良反应发生率50.00%,病死率8.89%;治疗组患者不良反应发生率为41.11%,病死率为6.67%,2组患者不良反应发生率、病死率比较差异均无统计学意义(χ2=1.43、0.31,P>0.05)。结论 EPO治疗老年脑梗死的临床效果显著,且神经功能可得到明显改善,具有较高的安全性。
Abstract:
Objective To explore the clinical efficacy and side effects of erythropoietin (EPO) in the treatment of senile cerebral infarction.Methods One hundred and eighty patients with senile cerebral infarction in the Department of Neurology,the People′s Hospital of Changyuan County from June 2015 to December 2016 were selected and divided into treatment group and control group,with 90 patients in each group.All patients were given conventional therapy;based on this,the patients in treatment group were given EPO.The clinical efficacy and side effects of patients in the two groups was observed.The area of cerebral infarction,neurological deficits (AS) and daily living status of patients were assessed and the concentration of serum C-reactive protein (CRP) was measured before and after treatment.Results The total effective rate of patients in treatment group (90.00%,81/90) was significantly higher than that in the control group (77.78%,70/90) (χ2=4.57,P<0.05).Before treatment,the area of cerebral infarction in control group and treatment group was (8.96±0.35),(9.01±0.23)cm2 respectively;after treatment,the area of cerebral infarction in control group and treatment group was (5.47±0.12),(4.03±0.48)cm2 respectively.There was no statistic difference in the area of cerebral infarction between the two groups before treatment(P>0.05).The areas of cerebral infarction in the two groups after treatment were significantly smaller than those before treatment(P<0.05);and the area of cerebral infarction in the treatment group after treatment was significantly smaller than that in the control group (P<0.05).There was no significant difference in assessment standard(AS),Barthel index (BI) score and serum CRP level between the two groups before treatment (P>0.05).The AS score and serum CRP levels in the two groups after treatment were significantly lower than those before treatment(P<0.05);but the BI score was significantly higher than that before treatment (P<0.05).After treatment,the AS score and serum CRP levels of patients in the treatment group were significantly lower than those in the control group,but the BI score was significantly higher than that in the control group(P<0.05).The incidence of adverse reactions and mortality of patients in the control group was 50.00%,8.89% respectively;the incidence of adverse reactions and mortality of patients in the treatment group was 41.11%,6.67% respectively;there was no significant difference in the incidence of adverse reactions and mortality between the two group(χ2=1.43,0.31;P>0.05).Conclusion EPO for treatment of senile cerebral infarction has good clinical effect and high safety,and it can improve the neurological function distinctly.

参考文献/References:

[1] ARMSTRONG C W,BOSIO E,NEIL C,et al.Distinct inflammatory responses differentiate cerebral infarct from transient ischaemic attack[J].J Clin Neurosci,2017,35(2):97-103.
[2] WANG R,WU X,LIANG J,et al.Intra-artery infusion of recombinant human erythropoietin reduces blood-brain barrier disruption in rats following cerebral ischemia and reperfusion[J].Int J Neurosci,2015,125(9):693-702.
[3] HAN M,CHOI J W,RIM N J,et al.Cerebral infarct volume measurements to improve patient selection for endovascular treatment[J].Medicine (Baltimore),2016,95(35):e4702.
[4] 冯光坤,牛建花,朱海英,等.中青年与老年脑梗死患者的病因及危险因素研究[J].中国全科医学,2012,15(6B):1940-1942.
[5] GRESIR E,VASILIADIS N,KONCZALLA J,et al.Erythropoietin prevents delayed hemodynamic dysfunction after subarachnoid hemorrhage in a randomized controlled experimental setting[J].J Neurol Sci,2013,332(1/2):128-135.
[6] 王琪,魏俊,李小琴.尤瑞克林注射液治疗急性脑梗死的疗效及安全性[J].新乡医学院学报,2016,33(11):980-982.
[7] 周伟宏,吴永华,张俐.促红细胞生成素对急性脑梗死患者血清的MMP-9、TNF-ɑ、VEG影响及疗效观察[J].实用老年医学,2012,26(5):437-438.
[8] BRINES M L,GHEZZI P,KEENAN S,et al.Erythropoietin crosses the blood-brain barrier to protect against experimental brain injury[J].Proc Natl Acad Sci USA,2000,97(19):10526-10531.
[9] LI Y,LU Z,KEOGH C L,et al.Erythropoietin-induced neurovascular protection,angiogenesis,and cerebral blood flow restoration after focal ischemia in mice[J].J Cereb Blood Flow Metab,2007,27(5):1043-1054.
[10] MENON D K,MAAS A I.EPO in traumatic brain injury:two strikes-but not out[J].Lancet,2015,386(10012):2452-2454.
[11] YATSIV I,GRIGORIADIS N,SIMEONIDOU C,et al.Erythropoietin is neuroprotective,improves functional recovery,and reduces neuronal apoptosis and inflammation in a rodent model of experimental closed head injury[J].FASEB J,2005,19(12):1701-1703.
[12] ROMANOVA G A,SHAKOVA F M,BARSKOV I V,et al.Neuroprotective and antiamnesic effect of erythropoietin derivatives after experimental ischemic injury of cerebral cortex[J].Bull Exp Biol Med,2015,158(3):318-321.

相似文献/References:

[1]王泰安.复方丹参联用纳络酮治疗急性脑梗死31例[J].新乡医学院学报,2001,18(04):278.
[2]陈 娟,吕文国.黄芪注射液联合复方丹参注射液治疗急性脑梗死30例[J].新乡医学院学报,2002,19(02):083.
[3]李素芳,王艳.降纤酶联用低分子肝素治疗脑梗死疗效观察[J].新乡医学院学报,2002,19(06):502.
[4]刘世峰,刘江峰.降纤酶与东菱克栓酶治疗急性脑梗死的临床对照观察[J].新乡医学院学报,2002,19(04):291.
[5]张思莲.脑梗死患者患侧股骨颈骨折术后护理[J].新乡医学院学报,2002,19(05):441.
[6]汪裕荣.灯盏花注射液治疗急性脑梗死128例[J].新乡医学院学报,2002,19(01):050.
[7]丁泽昌,吕荣亚.降纤酶治疗脑梗死40例临床疗效观察[J].新乡医学院学报,2003,20(06):438.
[8]崔光琴,王凯。.脑梗死70例急性期血压变化[J].新乡医学院学报,2003,20(06):447.
[9]张晨光,沈琪琳,马振武,等.急性脑梗死患者血液流变学及血细胞参数的变化[J].新乡医学院学报,2003,20(03):177.
[10]周俐红,陈 娟.老年脑梗死合并感染30例分析[J].新乡医学院学报,2003,20(03):210.

更新日期/Last Update: 2017-07-05