前列地尔对脑卒中冠状动脉旁路移植术神经系统影响研究  

Prophylactic Study of Alprostadil on Postoperative Neurological Complications of Stroke Patients Undergoing Coronary Artery Bypass Grafting

作　　者：方晓霞[1] 王云甫[1] 胡伟[1] 张跃亮 杨新春[2] 

机构地区：[1]湖北医药学院附属太和医院,湖北十堰442000 [2]首都医科大学附属安贞医院,北京100029

出　　处：《现代生物医学进展》2015年第21期4105-4108,共4页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(30770875)

摘　　要：目的:分析前列地尔在脑卒中患者冠状动脉旁路移植(CABG)术后对患者神经系统并发症预防性的影响。方法:选取首都医科大学附属安贞医院心外科六病区的收治脑卒中冠状动脉旁路移植术后患者60例,随机分为两组,每组30例患者,其中对照组予常规肠外营养(PN)治疗,实验组加用前列地尔治疗。对比治疗前后两组患者神经系统功能及临床疗效。结果:1治疗后2组患者临床症状均有所减轻,实验组总有效率(100%)率明显优于对照组(80.0%),差异有显著的统计学意义(P<0.05);2治疗结束后,实验组和对照组分别有4例、9例患者出现神经系统并发症状,实验组神经系统并发症的发生率为13.3%明显低于对照组30%,差异有统计学意义(P<0.05)。3经logistic回归分析统计,术后神经系统并发症影响因素与性别无明显差异(P>0.05),与颈动脉重度狭窄、缺血缺氧性脑病以及脑卒中存在差异,有显著的统计学意义(P<0.05)。结论:前列地尔注射液能有效的预防脑卒中患者CABG术后预防神经系统并发症,对临床具有指导意义。Objective： To analyze the impact of alprostadil on neurological complications in stroke patients undergoing coronary artery bypass grafting （CABG）. Methods： 60 patients were admitted for stroke and treated with coronary artery bypass graft in An Zhen Hospital affiliated to Capital Medical University, then these eases were randomly divided into two groups, including 30 eases in the con- trol group, treated with conventional parenteral nutrition （PN） therapy, 7d for a course of treatment, total two courses; experimental group of 30 patients who were given alprostadil based on the conventional treatment, 20 μg / times / day intravenously, 7d for a course of treat- ment, total two courses. After the end of treatment, the clinical efficacy and the neurological preventive effects were compared between the two groups. Results： ① After the treatment, the clinical symptoms were reduced in both two groups, and the total effective rate in ex- perimental group （100.0 %） was significantly.better than that of the control group （80.0 %）, the difference was statistically significant （P 〈0.05）. ② after treatment, there were four cases, nine cases of neurologic complications in experimental group and control group, respec- tively. The occurrence rate of neurologic complications in the experimental group was 13.3 %, significantly lower than the 30 % in the control group, the difference was statistically significant （P 〈0.05）. ③ After logistic regression analyzes, the factors of postoperative neu- rological complications had no significant relation with gender difference （P〉0.05）, but had a correlation with severe carotid artery steno- sis, hypoxie ischemic encephalopathy and stroke, with significant statistical significance （P 〈0.05）. Conclusions： Alprostadil injection can effectively prevent the neurologic complications after CABG in the patients with stoke, worthy of clinical application.

关 键 词：脑卒中 冠状动脉旁路移植术 前列地尔 神经系统并发症 

分 类 号：R541.4[医药卫生—心血管疾病] R743[医药卫生—内科学]