维生素D辅助治疗脑梗死的临床疗效及对患者复发率的影响  

Therapeutic effects of vitamin D adjuvant therapy and its influence on reoccurrence rate of cerebral infarction

作　　者：魏晓珊[1] 张锐利[2] 袁坤[1] 陈励竞 石会[1] WEI Xiaoshan;ZhANG Ruili;YUAN Kun(Department of Neurology,Shijiazhuang Hospital of Traditional Chinese Medicine,Hebei,Shijiazhuang 050000,China)

机构地区：[1]河北省石家庄市中医院神经内一科,050000 [2]河北省遵化市人民医院神经内科

出　　处：《河北医药》2018年第6期894-897,共4页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题计划(编号:20150926)

摘　　要：目的探讨维生素D辅助治疗对急性脑梗死患者临床治疗效果和短期复发率生存率的影响。方法将105例脑梗死患者随机分为干预组和对照组,每组50例。2组患者均给予抗血小板,营养脑细胞和改善脑循环等治疗,在此基础上干预组给予维生素D滴剂胶囊口服,观察治疗前和治疗后6个月神经功能缺损程度评分(NIHSS评分)、肢体运动功能(改良Fug1-Meyer运动功能评分)、日常生活能力(Barthel指数)等指标的变化情况,观察大脑中动脉血流变化情况(最大峰值流速、舒张未流速、平均血流速度、血流阻力指数),随访1年和2年观察患者复发及存活情况。结果 2组治疗前NIHSS评分、改良Fug1-Meyer运动功能评分、Barthel指数及大脑中动脉脑血流动力学等指标比较,差异无统计学意义(P>0.05),经过6个月的治疗后发现干预组NIHSS评分明显低于对照组,而改良Fug1-Meyer运动功能评分、Barthel指数、最大峰值流速,舒张末流速,平均血流速度和血流阻力指数明显高于对照组,差异均有统计学意义(P<0.05),干预组在1年和2年内累积复发率低于对照组,而累积生存率明显高于对照组,差异均有统计学意义(P<0.05),2组均未发生明显的不良反应。结论维生素D辅助治疗急性脑梗死可以有效改善患者神经功能缺损及脑血流动力学,具有一定的临床应用价值。Objectives To explore the effects of vitamin D adjuvant therapy on relapse rate and survival rate of patients with acute cerebral infarction.Methods A total of 105 patients with cerebral infarction were randomly divided into control group(n=55)and intervention group(n=50).The patients in both groups were treated by antiplatelet drugs,nourishing brain cells and improving cerebral circulation.However the patients in intervention group were treated by vitamin D drop capsule.The changes of neurological function deficit,limb motor function,activity of daily living and blood flow in middle cerebral artery of patients before treatment and at 6 months after treatment were observed and compared between two groups.Moreover the relapse rate and survival rate of patients were followed up for one to two years.Results Before treatment there were no significant differences in NIHSSscores,improved Fug1-Mey ermotor function scores,Barthel index and hemodynamics indexes of middle cerebral artery between two groups(P>0.05).After 6-month treatment,the NIHSS scores in intervention groups were obviously lower than those in control group,but improved Fug1 Meyer motor function scores,Barthel index,maximum peak flow velocity,end of diastolic velocity,average blood flow velocity and blood flow resistant index in intervention groups were significantly higher than those in control group(P<0.05).Moreover the accumulation relapse rates within one and two years in intervention group were significantly lower than those in control group,however,the accumulation survical rates in intervention group were significantly higher than those in control group(P<0.05).In addition no obvious adverse reactions were found in both groups.Conclusion The vitamin D adjuvant therapy of acute cerebral infarction can effectively improve neurological functional deficit and cerebral hemodynamics of patients,which has a certain clinical application value.

关 键 词：脑梗死 维生素D 神经功能 血流动力学 复发 

分 类 号：R743.33[医药卫生—神经病学与精神病学]