不同剂量川芎嗪辅助手术治疗老年人突发脑梗死的预后研究  

Prognosis of Elderly Patients With Sudden Cerebral Infarction After Surgical Treatment Aided by Different Doses of Ligustrazine

作　　者：呼建民 王述莲[2] 刘献增[3] 

机构地区：[1]武警北京市总队第三医院内一科,北京市100141 [2]武警北京市总队第三医院检验科,北京市100141 [3]北京大学人民医院神经功能科

出　　处：《中国全科医学》2016年第20期2390-2394,共5页Chinese General Practice

基　　金：北京大学人民医院研究与发展基金资助项目(RDC2010-06)

摘　　要：目的探讨不同剂量川芎嗪辅助手术治疗老年人突发脑梗死对预后的影响。方法选取2012年6月—2014年12月武警北京市总队第三医院诊治的110例老年突发脑梗死患者,采用随机平行对照的方法将患者分为对照组和治疗组,各55例。两组患者均行基础治疗及腰椎穿刺或腰大池置管引流术,对照组给予大剂量川芎嗪注射液辅助治疗,川芎嗪注射液160 mg加入0.9%氯化钠溶液250 ml中静脉滴注;治疗组给予小剂量川芎嗪注射液辅助治疗,川芎嗪注射液40 mg加入0.9%氯化钠溶液250 ml中静脉滴注。两组均治疗14 d。观察两组患者治疗后疗效及神经功能缺损评分,测定血管紧张素Ⅱ（AngⅡ）与溶血磷脂酸（LPA）水平,并记录治疗期间不良反应发生情况。结果治疗后,治疗组和对照组的有效率分别为96.4%（53/55）和80.0%（44/55）,治疗组有效率高于对照组（χ~2=6.445,P〈0.05）。治疗前,两组神经功能缺损评分比较,差异无统计学意义（P〉0.05）;治疗后,治疗组神经功能缺损评分低于对照组（P〈0.05）;两组治疗后神经功能缺损评分均低于同组治疗前（P〈0.05）。治疗前,两组AngⅡ、LPA水平比较,差异均无统计学意义（P〉0.05）;治疗后,治疗组AngⅡ、LPA水平均低于对照组（P〈0.05）;两组治疗后AngⅡ、LPA水平均低于同组治疗前（P〈0.05）。两组在治疗期间均未出现出血、发热、皮疹、肝肾功能损伤等不良反应。结论相对于大剂量,小剂量川芎嗪辅助手术治疗老年人突发脑梗死能更加有效地改善神经功能,提高疗效,安全性较好,其作用机制可能与促进血浆AngⅡ与LPA表达下调有关。Objective To investigate the influence of different doses of ligustrazine used in surgical treatment on elderly patients with sudden cerebral infarction. Methods From June 2012 to December 2014,we selected 110 elderly patients with sudden cerebral infarction who received diagnosis and treatment in the Third Hospital of Chinese People＇ s Armed Police Forces. Random parallel control method was used to divide patients into control group and treatment group,with 55 patients in each group. All patients were given basic treatment and lumbar puncture or lumbar cistern drainage. Control group was given high- dose ligustrazine injection adjuvant therapy with intravenous drip of 160 mg of ligustrazine and 250 ml of 0. 9% sodium chloride injection,and the treatment group was given low- dose ligustrazine injection adjuvant therapy with 40 mg of ligustrazine and 250 ml of 0. 9% sodium chloride injection. Both groups received the therapies for 14 days. Efficacy and neurological function defect scale of the two groups were observed,and the levels of AngⅡ and LPA were determined. Adverse reactions during treatment were recorded. Results After treatment,the effective rates of treatment group and control group were 96. 4%（ 53 /55） and 80. 0%（ 44 /55）,with treatment group higher than control group（ χ2= 6. 445,P〈 0. 05）. Before treatment,the two groups were not significantly different in the scores of neurological function defect scale（ P〉0. 05）; after treatment,treatment group was lower than control group in the scores of neurological function defect scale（ P〈0. 05）; the two groups had lower scores of neurological function defect scale after treatment than that before treatment（ P 〈0. 05）. Before treatment, the two groups were not significantly different in the levels of AngⅡ and LPA（ P〉0. 05）; after treatment,treatment group was lower than control group in the levels of AngⅡ and LPA（ P〈0. 05）; the two groups had lower levels of AngⅡ and LPA than those before treatment（ P〈0

关 键 词：脑梗死 药物剂量 川芎嗪 老年人 血管紧张素Ⅱ 溶血磷脂酸类 

分 类 号：R743.33[医药卫生—神经病学与精神病学]