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[摘要]
目的 探讨注射用丹参多酚酸联合尤瑞克林治疗急性心源性脑梗死(ACCE)的临床疗效及安全性。方法 选择驻马店市中心医院收治的102例ACCE患者,随机分为对照组和观察组,每组各51例,全部患者均予以静脉滴注0.5 g胞磷胆碱钠注射液+250 mL生理盐水,每日1次,予以口服100 mg阿司匹林肠溶片+20 mg阿托伐他汀片,每日1次。对照组患者在以上治疗的基础上予以静脉滴注0.15 PNA尤瑞克林+100 mL生理盐水,每日1次。观察组患者在对照组治疗的基础上予以静脉滴注100 mg丹参多酚酸+250 mL生理盐水进行治疗,每日1次。一个疗程为14 d。观察指标:(1)对两组患者治疗前后的神经功能缺损情况、功能恢复水平进行观察分析;(2)对两组患者的临床疗效进行评价;(3)对两组患者治疗前后的血液流变学指标(全血高切黏度、全血低切黏度、血浆黏度、红细胞压积、纤维蛋白原、血小板黏附率)进行记录比较;(4)对两组患者治疗过程中的不良反应(恶心、呕吐、头晕、头痛)进行统计分析。结果 两组患者治疗后的NIHSS评分及mRS评分均显著低于治疗前(P<0.01),且观察组患者治疗后的NIHSS评分均显著低于对照组(P<0.01)。观察组的总有效率显著高于对照组(96.08% vs 76.47%,P<0.01)。两组患者治疗后的全血高切黏度、全血低切黏度、血浆黏度、红细胞压积、纤维蛋白原水平及血小板黏附率显著低于治疗前(P<0.05),且观察组患者治疗后的全血高切黏度、全血低切黏度、血浆黏度、红细胞压积、纤维蛋白原水平及血小板黏附率显著低于对照组(P<0.05)。两组患者之间的不良反应率比较差异无统计学意义。结论 ACCE缓和采用注射用丹参多酚酸联合尤瑞克林较单纯采取尤瑞克林临床疗效较好,能够显著降低患者的血液黏滞度,改善患者的神经功能缺损情况,提高患者治疗后的日常生活功能水平,且不良反应发生率未发生明显变化,用药安全性好。
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[Abstract]
Objective To explore the clinical efficacy and safety of Salvianolic Acids for Injection combined with urinary kallikrein in the treatment of acute cardiogenic cerebral embolism (ACCE). Methods One hundred and two patients with ACCE in our hospital were randomly divided into the control group and the observation group, 51 cases in each group. All patients were given intravenous drip of 0.5 g citicoline sodium injection + 250 mL saline and oral administration of 100 mg Aspirin enteric-coated tablets +20 mg atorvastatin tablet, once a day. One course of treatment lasted 14 days. The neurological deficits and functional recovery levels of the two groups before and after treatment were observed and analyzed. The clinical efficacy of two groups of patients was evaluated. The hemorrheology indexes (Whole blood high shear viscosity, whole blood low shear viscosity, plasma viscosity, hematocrit, fibrinogen, platelet adhesion rate) of the two groups before and after treatment were recorded and compared. The adverse reactions (nausea, vomiting, dizziness, headache) in the two groups were analyzed statistically. Results The NIHSS scores and mRS scores of the two groups after treatment were significantly lower than those before treatment (P<0.01), the NIHSS score of the observation group after treatment was significantly lower than that of the control group (P<0.01). The total effective rate of the observation group was significantly higher than that of the control group (96.08% vs 76.47%, P<0.01). The total blood viscosity, low shear viscosity, plasma viscosity, hematocrit, fibrinogen level and platelet adhesion rate after treatment in the two groups were significantly lower than those before treatment (P<0.05), the total blood viscosity, low shear viscosity, plasma viscosity, hematocrit, fibrinogen level and platelet adhesion rate in the observation group were significantly lower than those in the control group (P<0.05). There was no significant difference in the rate of adverse reactions between the two groups. Conclusion Salvianolic Acids for Injection combined with urinary kallikrein is better than pure urinary kallikrein in treating acute cardiogenic cerebral embolism, it can significantly reduce the blood viscosity of patients, improve the neurological deficit and improve the daily life function after treatment. The incidence of adverse reactions did not increase significantly, so its safety can also be proved.
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