川芎嗪对心肺复苏后脑缺血-再灌注损伤的保护作用  

Protective effects of tetramethylpyrazine in patients with acute cerebral ischemia/reperfusion injury after cardiopulmonary resuscitation

作　　者：楼正家[1] 诸葛丽敏[1] 郑文龙[1] 欧阳侃[1] 寿璐[1] 

机构地区：[1]杭州市中医院急诊科,浙江杭州310007

出　　处：《中国中西医结合急救杂志》2003年第5期299-301,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

摘　　要：目的 :观察川芎嗪对心肺复苏后对脑损伤的保护作用及其机制。方法 :将 4 2例需行心肺复苏患者按随机数表法分为治疗组 (A组 )与对照组 (B组 )。 A组 2 2例在心肺复苏开始同时给予川芎嗪 2 4 0 mg加质量分数为 5 %的葡萄糖 2 5 0 ml中静脉滴注 ,1h滴完 ,其后按上述剂量每日 1次 ,连用 7d。B组除不用川芎嗪外 ,其他治疗同 A组。检测两种治疗方法对患者血中超氧化物歧化酶 (SOD)、丙二醛 (MDA)、血栓素 B2 (TXB2 )的影响 ;并以意识恢复为主要指标评定临床疗效。结果 :A组显效 16例 (72 .72 % ) ,有效 3例 (13.6 4 % ) ,无效 3例(13.6 4 % ) ;B组显效 8例 (40 .0 0 % ) ,有效 3例 (15 .0 0 % ) ,无效 9例 (45 .0 0 % ) ,两组之间差异显著 (P<0 .0 5 )。两组治疗后静脉血 SOD、MDA和 TXB2 均有改善 ,但 A组改善程度明显优于 B组 (P均 <0 .0 1)。结论 :川芎嗪能对抗脂质过氧化 ,提高 SOD活性 ,抑制血小板活化 ,对心肺复苏后脑缺血再灌注损伤有一定的保护作用 ,早期应用可提高脑复苏成功率。Objective: To evaluate the protective effects of tetramethylpyrazine on acute cerebral ischemia/reperfusion injury in patients after cardiopulmonary resuscitation. Methods: Fortytwo cases who were going to be treated with cardiopulmonary resuscitation were randomly divided into two groups, 22 cases in treatment group(A group) and 20 cases in control group (B group). Both groups were treated with tetramethyplyrazine 240 mg added 5% glucose 250 ml infused intravenously for 1 hour, once a day for 7 days. The additional treatment of tetramethylpyrazine infusion was administered in A group while in B group was not. The changes of plasma superoxide dismutase (SOD), malondialdehyde (MDA) and thromboxane B 2 (TXB 2) were determined in each group before and after therapy. The conciousness recovery was as the main index to valuating the clinical curative effects. Results: The marked effective rate, effective rate and no effective rate in A group(72.72%, 13.64%, 13.64 %) was significantly higher than those in B group (40.00% , 15.00%, 45.00%, all P <0.05). The plasma SOD, MDA and TXB 2 levels were more remarkably improved in A group (all P <0.01). Conclusion: Treating with tetramethylpyrazine can restrain the over oxidation of lipid, bate the conglomeration of platelet and evaluate the activity of SOD,even can elevate the rate of cerebral resuscitation. It can prevent patients from acute cerebral ischemia/reperfusion injury after cardiopulmonary resuscitation.

关 键 词：川芎嗪 心肺复苏 脑缺血 缺血再灌注 作用机制 脂质过氧化 血小板活化 脑损伤 

分 类 号：R278[医药卫生—中医学]