心源性脑梗死溶栓联合丁苯酞氯化钠注射液疗效分析  

Therapeutic efficacy of intravenous butylphthalide sodium chloride plus thrombolysis in cardiogenic cerebral infarction

作　　者：韩斌[1] 胡风云[1] 刘毅[1] 李星 孙雅轩[1] 王晶[1] 孟坤 张鹏[1] Han Bin;Hu Fengyun;Liu Yi;Li Xing;Sun Yaxuan;Wang Jing;Meng Kun;Zhang Peng(Department of Neurology,Shanxi Provincial People's Hospital,Taiyuan 030012,China)

机构地区：[1]山西省人民医院神经内科,太原030012

出　　处：《中国药物与临床》2021年第8期1273-1277,共5页Chinese Remedies & Clinics

基　　金：山西省青年科技研究基金(201701D221172)。

摘　　要：目的探讨心源性脑梗死静脉溶栓、Solitaire AB支架取栓联合丁苯酞氯化钠注射液的安全性及有效性,评价其效果。方法采用单中心随机对照研究。总计入组急性缺血性卒中患者为45例,其中内科治疗组为15例,静脉溶栓组为15例,支架取栓组为15例;内科治疗组予以神经内科急性脑梗死常规内科治疗加丁苯酞注射液;静脉溶栓组予以:阿替普酶(rt-PA)或尿激酶静脉溶栓,联合丁苯酞注射液,加神经内科急性脑梗死常规内科治疗;支架取栓组予以Solitaire AB型支架,进行机械取栓,联合药物丁苯酞氯化钠注射液治疗,加神经内科急性脑梗死常规内科治疗,治疗时间为2周。采用美国国立卫生研究院卒中量表(NIHSS)评分、90 d改良Rankin量表(mRS)评分,以及血管再通率评定疗效,并发症和病死率来评定其安全性。结果治疗2周后3组患者NIHSS评分分析,较基线均显著降低(P<0.05),内科治疗组显效率为60%,静脉溶栓组显效率为67%,支架取栓组显效率为80%,组间差异具有统计学意义(P<0.05)。治疗90 d后,3组患者预后良好(mRS评分≤2)比例,内科治疗组33%,静脉溶栓组47%,支架取栓组67%,组间差异具有统计学意义(P<0.05)。血管再通率,内科治疗组20%,静脉溶栓组40%,支架取栓组53%,组间差异有统计学意义(P<0.05)。并发症发生率内科治疗组20%,静脉溶栓组13%,支架取栓组7%,静脉溶栓组及支架取栓组,低于内科治疗组,差异有统计学意义(P<0.05),支架取栓组低于静脉溶栓组,差异有统计学意义(P<0.05)。结论丁苯肽氯化钠注射液联合静脉溶栓和Solitaire AB支架取栓术应用于心源性脑梗死急性期治疗是有效且安全的。Objective To investigate the safety,effectiveness and outcomes of intravenous thrombolysis plus butylphthalide sodium chloride,with or without Solitaire AB stent-assisted thrombectomy,in patients with cardiogenic cerebral infarction.Methods In this single-center randomized controlled study,a total of 45 patients with acute ischemic stroke were enrolled and assigned to the medical treatment group(n=15),intravenous thrombolysis group(n=15),and stent-assisted thrombectomy group(n=15).The medical treatment group received conventional neurological treatment for acute cerebral infarction and intravenous butylphthalide injection;the intravenous thrombolysis group received intravenous thrombolysis using rt-PA or urokinase,in addition to butylphthalide injection and conventional neurological treatment for acute cerebral infarction;the stent-assisted thrombectomy group received mechanical thrombectomy via Solitaire AB stent,in addition to intravenous butylphthalide sodium chloride and conventional neurological treatment for acute cerebral infarction.The treatment course was two weeks.National Institutes of Health stroke scale(NIHSS)score,the 90-day modified Rankin scale(mRS)score,and the vascular recanalization rate were used to assess the therapeutic efficacy.The treatment safety was evaluated based on complications and mortality.Results After the 2-week treatment,the NIHSS scores in the three groups were significantly lower compared with the baseline(P<0.05).The treatment response was 60%in the medical treatment group,67%in the intravenous thrombolysis group,and 80%in the stent-assisted thrombectomy group,with statistically significant difference among groups(P<0.05).After 90 days of treatment,favorable prognosis(m RS score≤2)was noted in 33%of patients in the medical treatment group,46.7%the intravenous thrombolysis group,and 67%in the stent-assisted thrombectomy group,with statistically significant difference among groups(P<0.05).The vascular recanalization rate was 20%in the medical treatment group,40%in the intrave

关 键 词：丁苯酞氯化钠注射液 Solitaire AB型支架溶栓 脑梗死 

分 类 号：R743.33[医药卫生—神经病学与精神病学]