目的 观察前列地尔联合阿替普酶治疗急性脑梗死的临床疗效。方法 选择2011年12月-2015年4月烟台龙矿中心医院收治的急性脑梗死患者120例,随机分成对照组和治疗组,每组各60例。对照组给予注射用阿替普酶,5 mg溶于10 mL生理盐水中,10 s内静脉推注,45 mg溶于100 mL生理盐水中,60 min内静脉滴注。治疗组在对照组的基础上静脉滴注前列地尔注射液,20 μg溶于250 mL生理盐水,1次/d,两组患者均连续治疗14 d。观察两组的临床疗效,比较两组治疗前后国立卫生研究院卒中量表(NIHSS)评分、日常生活能力指数(BI)、血管再通情况和脑梗死灶体积。结果 治疗后,对照组和治疗组总有效率分别为86.67%、93.33%,两组总有效率比较差异具有统计学意义(P<0.05)。两组患者的NIHSS评分较治疗前明显下降,BI评分较治疗前明显升高,同组治疗前后差异有统计学意义(P<0.05);且治疗组NIHSS评分和BI评分的改善程度优于对照组,两组比较差异有统计学意义(P<0.05)。两组血管再通情况比较差异无统计学意义。两组患者的脑梗死灶体积均较治疗前明显缩小,同组治疗前后差异有统计学意义(P<0.05);且治疗组的治疗前后差明显大于对照组(P<0.05)。结论 前列地尔联合阿替普酶治疗急性脑梗死疗效显著,能够显著改善患者的神经功能缺损症状,提高日常生活活动能力,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacies of Kanglixin Capsules combined with mannatide in treatment of liver cancer. Methods Patients (86 cases) with liver cancer from February 2014 to July 2015 in People's Hospital of Yuxi City were divided into control group (43 cases) and treatment group (43 cases). All patients were given necessary chemotherapy and lipiodol embolization therapy, once a week, and were treated for 2 weeks. Based on the foresaid, the patients in the control group were iv administered with Mannatide Injection, 10 mg added into normal saline 250 mL, once daily. The patients in the treatment group were po administered with Kanglixin Capsules on the basis of the control group, 3 grains/time, three times daily. The patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the improvement of survival quality, immune function and serum matrix metalloproteinase levels in two groups were compared. Results After treatment, ORR and CBR in the control group were 41.86% and 74.42%, respectively, accordingly, 65.12% and 90.70% in the treatment group, and there were differences between two groups (P < 0.05). After treatment, improvement rate of survival quality in the control and treatment group were 74.42% and 93.02%, respectively, and the difference was statistically significant (P < 0.05). After treatment, CD³⁺, CD⁴⁺, and CD⁴⁺/CD⁸⁺ were increased (P < 0.05); And the changes of immune function in treatment were more significant than those in control group (P < 0.05). After treatment, the serum MMP-2 and MMP-9 levels decreased more significantly than those before treatment (P < 0.05). But the reduction in treatment group was more significant than those in the control group (P < 0.05). Conclusion Kanglixin Capsules combined with Mannatide Injection has a good clinical efficacy in the treatment of hepatocellular carcinoma, and can improve the immune function and survival quality, which has a certain clinical application value.