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[摘要]
目的 评价注射用丹参多酚酸治疗椎基底动脉系统短暂性脑缺血发作(TIA)的有效性和安全性。方法 选取2017年8月-2018年8月在哈尔滨市第二医院神经内三科住院的椎基底动脉系统TIA的患者76例,随机分成观察组和对照组。观察组39例,对照组37例,对照组采用抗血小板聚集和脑保护剂等常规治疗,观察组在对照组治疗的基础上加用注射用丹参多酚酸0.13 g,每日1次,60 min内静脉滴注,连续给药14 d。对治疗后患者分别评定疗效以及不良反应。实验室指标包括血尿常规、肝肾功能、空腹血糖、血脂,治疗前及治疗后各检查1次,头CT或MRI、心电图在治疗前和治疗后各检查1次。治疗后随访3个月,观察病情变化,统计TIA转化成脑梗死的发生情况。结果 观察组治疗后3个月内TIA再次发作次数平均为(1.61±0.52)次,3个月内脑梗死发生4例,均留有轻度神经功能缺损表现,发生率为10.26%;对照组治疗后3个月内TIA再次发作次数平均为(3.12±0.49)次,3个月内脑梗死发生11例,均有轻度神经功能缺损表现,其中l例治疗期间发生急性脑梗死后静脉溶栓治疗,治疗后留有严重神经功能缺损表现,脑梗死发生率为29.37%。治疗后观察组的效果显著优于对照组(P<0.05)。复查实验室指标即血尿常规、肝肾功能、空腹血糖、血脂,无新发异常病例,原指标异常者复查结果较用药前无明显变化。结论 应用注射用丹参多酚酸观察组显示出良好的临床疗效,可有效控制椎基底动脉系统TIA,缓解血管痉挛症状;在治疗过程中两组均未发现明显的肝肾功能异常及其他不良反应,具有良好的用药安全性,丹参多酚酸治疗椎基底动脉系统TIA安全有效。
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[Abstract]
Objective To evaluate the efficacy and safety of Salvianolic Acids for Injection for transient ischemic attack. Methods Seventy-six patients of transient ischemic attack in the Harbin NO.2 Hospital of from August, 2017 to August, 2018 were divided into treatment group and control group randomly. Patients in treatment group received routine therapy and Salvianolic Acids for Injection, and patients in control group received routine therapy only. To evaluate the efficacy of treatment. Meantimes, clinical experience including CT, MRI, BP and HR before operation, before treatment and during seven days. Blood examination (WBC, RBC, ALT, AST, BUN, Cr) should be performed during seven days. Results In the observation group, the average number of TIA recurrences within 3 months after treatment was (1.61 + 0.52). Four cases of cerebral infarction occurred within 3 months, all of which had mild neurological deficits, with an incidence of 10.26%. The average number of TIA recurrences within 3 months after treatment in the control group was (3.12 + 0.49) times, and 11 cases of cerebral infarction occurred within 3 months. All of them had mild neurological deficits. Among them, 1 case had intravenous thrombolysis after acute cerebral infarction during treatment, and severe neurological deficits remained after treatment. The incidence of cerebral infarction was 29.37%. After treatment, χ2 test showed that the effect of the observation group was significantly better than that of the control group (P<0.05). From side effect, Salvianolic Acids for Injection did not decrease the systemic blood pressure and maybe better than others in the safety. Conclusion Salvianolic Acids for Injection was effective and safe for transient ischemic attack.
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