高压氧联合替罗非班治疗急性缺血性脑卒中25例  

Research on Therapeutic Effect of Hyperbaric Oxygen Combined with Tirofiban on Acute Ischemic Stroke

作　　者：杨卉[1] 林香玉[1] 马巧玲[1] 

机构地区：[1]山东省烟台市烟台山医院,山东烟台264000

出　　处：《中国药业》2009年第23期49-50,共2页China Pharmaceuticals

摘　　要：目的评价高压氧联合替罗非班治疗急性缺血性脑卒中的临床疗效,及其对血凝、脑血流方面的影响。方法选择急性缺血性脑卒中患者25例作为治疗组,采用高压氧联合替罗非班治疗,在入院时及治疗后15d对患者进行神经功能缺损评分,监测入院时和治疗后国际正常化比值(INR)和血D-二聚体、纤维蛋白含量的变化,并以多普勒监测脑血流。对照组为既往替罗非班治疗的20例患者。结果两组患者神经功能缺损评分均较治疗前显著提高(P<0.01),治疗组改善较对照组明显(P<0.05);治疗组治疗后血D-二聚体水平均较对照组低(P<0.05),Fg水平较高(P<0.05),INR无显著性差异(P>0.05);治疗组治疗后血流速度加快(P<0.01或P<0.05),阻力指数降低(P<0.05),对照组变化无统计学差异。结论急性缺血性脑卒中患者急性期使用高压氧联合替罗非班治疗,能降低神经功能受损程度,改善重症卒中预后、血凝状态及脑供血。Objective To evaluate the therapeutic effect and its possible mechanism of hyperbaric oxygen（HBO） combined with tirofiban on acute ischemic stroke. Methods 25 patients with acute ischemic stroke as the treatment group were treated with HBO and tirofiban. Neural functional deficiencies were assessed by the NIH Stroke Scale（NIHSS） at admission and after 15d treatment. At the same time, the variation of the International Normalised Ratio （INR）, D-dimer（D-D） and fibrinogen（Fg） were detected. The blood flow of ACA, MCA, PCA was also detected with TCD. 20 patients treated by tirofiban were as control. Results The neural functions assessed by NIHSS were significantly improved in both groups after treatment（P〈0. 01）, while the grades in HBO group were significantly greater than those in the control group. D- D level was significantly lower and Fg was significantly higher in HBO group compared with the control group. The average blood flow of MCA and ACA in HBO group was more significantly improved than that of the control group. Conclusion The combination therapy of HBO combined with tirofiban can decrease the damage degree of neural function and improve prognosis, coagulation state and cerebral blood supply in the patients with acute ischemic stroke.

关 键 词：高压氧 替罗非班 急性缺血性脑卒中 

分 类 号：R969.4[医药卫生—药理学] R973.2[医药卫生—药学]