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生脉注射液对轻中度脑梗死超时间窗rt-PA溶栓患者预后的影响
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| 篇名： | 生脉注射液对轻中度脑梗死超时间窗rt-PA溶栓患者预后的影响 |
| TITLE： | |
| 摘要： | 目的：探讨生脉注射液对电子计算机断层扫描（CT）指导下轻中度脑梗死超时间窗注射用阿替普酶（rt-PA）溶栓患者预后的影响。方法： 168例超时间窗的轻中度脑梗死患者按随机数字表法分为对照组（84例）和观察组（84例）。对照组患者给予rt-PA（0.9 mg/kg），将使用总剂量10％的rt-PA在1 min内静脉推注入患者体内，剩余90％的药物加入0.9％氯化钠注射液250 ml中静脉滴注（持续时间不短于1 h），溶栓治疗24 h后行CT检查，复查确认无脑内出血后给予口服阿司匹林300 mg/d，连用10 d，后改为100 mg/d继续口服90 d，同时，酌情给予他汀类调脂药、钙拮抗药、β受体阻滞药、硝酸酯类药。观察组患者在对照组治疗的基础上加用生脉注射液40 ml加入5％葡萄糖注射液250 ml中静脉滴注，每天1次，连用28 d。观察两组患者的美国国立卫生研究院卒中量表（NIHSS）评分、改良的Rankin评分、日常生活能力表-巴氏指数（Barthel）评分变化和溶栓治疗后48 h内症状性颅内出血情况、继发性出血情况、住院时间、术后3个月死亡情况及不良反应发生情况。结果：治疗前，两组患者NIHSS评分、改良的Rankin评分、Barthel评分比较，差异均无统计学意义（P＞0.05）。治疗6 h、24 h、7 d后两组患者NIHSS评分显著低于同组治疗前，且治疗24 h、7 d后观察组低于对照组；治疗3个月后两组患者改良的Rankin评分显著低于同组治疗前，且观察组低于对照组；治疗3个月后两组患者Barthel评分显著高于同组治疗前，且观察组高于对照组，差异均有统计学意义（P＜0.05）。观察组患者住院时间显著短于对照组，术后3个月死亡率显著低于对照组，差异均有统计学意义（P＜0.05）。两组患者治疗期间未见明显不良反应发生。结论：在常规治疗的基础上加用生脉注射液对CT指导下轻中度脑梗死超时间窗rt-PA溶栓患者预后有改善作用，可降低NIHSS评分、改良的Rankin评分，提高Barthel评分，缩短住院时间，降低术后3个月死亡率，且安全性较好。 |
| ABSTRACT： | OBJECTIVE： To explore the prognosis effect of Shengmai injection to the rt-PA thrombolysis on broadened therapeutic window patients of mild-to-moderate cerebral infarction under the guidance of computer tomography（CT）. METHODS： 168 patients with mild-to-moderate cerebral infarction were randomly divided into control group （84 cases） and observation group （84 cases）. Control group received rt-PA （0.9 mg/kg）， and 10％ of the total rt-PA was mixed and injected into patients within 1 min， the rest 90％ adding into 250 ml 0.9％ Sodium chloride injection （no less than 1 h）， CT was performed after 24 h thrombolytic therapy， and the patients with no intracerebral hemorrhage in re-examination received 300 mg/d aspirin for 10 d， then 100 mg/d for 90 d， and appropriate statins， calcium antagonists， β-blockers and nitrates； observation group additionally received 40 ml Shengmai injection， adding into 250 ml 5％ Glucose injection， intravenous infusion， once a day， for 28 d. National Institutes of Health Stroke Scale （NIHSS） score， Rankin score， daily living-Barthel Index （Barthel） score， rate of symptomatic intracranial hemorrhage， rate of secondary hemorrhage， hospitalization time， 3-month postoperative mortality and incidence of adverse reactions in 2 groups were observed. RESULTS： Before treatment， there were no significant differences in the NIHSS score， Rankin score and Barthel score （P＞0.05）. The NIHSS score in 2 groups after 6 h， 24 h and 7 d were significantly lower than before， and observation group was lower than control group after 24 h and 7 d；Rankin score after 3 months was significantly lower than before， and observation group was lower than control group； Barthel score after 3 months was significantly higher than before， and observation group was higher than control group， The differences were statistically significant （P＜0.05）. The hospitalization time in observation group was significantly shorter than in control group， and 3-month postoperative mortality was significantly lower than control group， the differences were statistically significant （P＜0.05）. There were no obvious adverse reactions during treatment. CONCLUSIONS： Based on conventional treatment， Shengmai injection has improvement in the rt-PA intravenous thrombolysis on broadened therapeutic window patients of mild-to-moderate cerebral infarction under the guidance of CT， it can reduce NIHSS score and Rankin score， increase Barthel score， shorten hospitalization time and reduce the 3-month postoperative mortality， with good safety. |
| 期刊： | 2016年第27卷第21期 |
| 作者： | 张卫国，王素洁，刘海燕 |
| AUTHORS： | ZHANG Weiguo，WANG Sujie，LIU Haiyan |
| 关键字： | 生脉注射液；轻中度脑梗死；超时间窗；注射用阿替普酶；溶栓；预后 |
| KEYWORDS： | Shengmai injection； Mild-to-moderate cerebral infarction； Beyond the optimal time-window；rt-PA thrombolysis； Thrombolytic； Prognosis |
| 阅读数： | 568 次 |
| 本月下载数： | 1 次 |
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