疏血通注射液联合阿替普酶治疗急性缺血性脑卒中的效果及对血液流变学的影响  

Efficacy of Shuxuetong injection combined with alteplase in treatment of acute ischemic stroke and the effect on hemorheology

作　　者：哈玲梅 杨丽荣 张赛 涂悦 刘洋 Ha Lingmei;Yang Lirong;Zhang Sai;Tu Yue;Liu Yang(Department of Emergency Medicine,Featured Medical Center of the Chinese People's Armed Police Force,Tianjin 300162,China;Brain Center,Featured Medical Center of the Chinese People's Armed Police Force,Tianjin 300162,China;Department of Neurology,Shanghai Minhang District Central Hospital,Shanghai 201199,China)

机构地区：[1]中国人民武装警察部队特色医学中心急诊医学科,天津300162 [2]中国人民武装警察部队特色医学中心脑科中心,天津300162 [3]上海市闵行区中心医院神经内科,201199

出　　处：《中国医药》2020年第3期378-382,共5页China Medicine

基　　金：国家自然科学基金(31200809);天津市科技计划(15ZXLCSY00040);上海市虹口区卫生和计划生育委员会医学科研课题(虹卫1802-06)。

摘　　要：目的观察疏血通注射液联合阿替普酶治疗急性缺血性脑卒中的效果及对血液流变学的影响。方法选取2018年6月至2019年3月在中国人民武装警察部队特色医学中心住院并接受治疗的98例急性缺血性脑卒中患者,完全随机分为对照组和观察组,每组49例。对照组给予注射用阿替普酶和阿司匹林肠溶片治疗,观察组在阿替普酶静脉溶栓基础上给予疏血通注射液治疗,2组均治疗14 d。观察2组治疗前和治疗1、7、14 d后美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数(BI)量表评分及全血高切黏度(HSV)、全血低切黏度(LSV)、血浆黏度、血细胞比容(HCT)、红细胞沉降率(ESR)变化,并比较2组临床疗效。结果观察组治疗7、14 d后NIHSS评分明显低于对照组,BI量表评分明显高于对照组,HSV、LSV、血浆黏度、HCT和ESR均明显低于对照组,差异均有统计学意义(均P<0.05)。观察组总有效率明显高于对照组[89.8%(44/49)比73.5%(36/49)],差异有统计学意义(P=0.04)。结论疏血通注射液联合阿替普酶治疗急性缺血性脑卒中患者可更好地促进神经功能恢复、提高生活能力,改善血液流变学指标,提高临床疗效。Objective To analyze the clinical effect of Shuxuetong injection combined with alteplase on acute ischemic stroke and hemodynamics of patients.Methods A total of 98 patients with acute ischemic stroke hospitalized in Featured Medical Center of the Chinese People’s Armed Police Force from June 2018 to March 2019 were randomly divided into control group and observation group,with 49 cases in each group.The control group was treated with ateplase injection and aspirin enteric-coated tablets.The observation group was treated with Shuxuetong injection on the basis of intravenous thrombolysis with ateplase.Both groups were treated for 14 d.National Institute of Health Stroke Scale(NIHSS)and Barthel index(BI)score,whole blood high shear viscosity(HSV),low cut viscosity(LSV),plasma viscosity(PSV),hematocrit(HCT)and erythrocyte sedimentation rate(ESR)were measured before and 1,7,14 d after treatment.Clinical efficacy was analyzed.Results After treatment,NIHSS scores at 7,14 d in observation group were significantly lower and BI scores were higher than those in control group;HSV,LSV,PSV,HCT and ESR at 7,14 d in observation group were significantly lower than those in control group(all P<0.05).The total effective rate in observation group was significantly higher than that in control group[89.8%(44/49)vs 73.5%(36/49)](P=0.04).Conclusion Combination of Shuxuetong and alteplase treating acute ischemic stroke patients can effectively promote the recovery of neurological function,living ability,hemorheology and improve the clinical efficacy.

关 键 词：急性缺血性脑卒中 血液流变学 疏血通注射液 阿替普酶 

分 类 号：R743.3[医药卫生—神经病学与精神病学]