【作者】 杨丽丽；

【导师】 阎伟；

【作者基本信息】 吉林大学 ， 神经内科， 2004， 硕士

【摘要】 脑梗死(CI)是最常见的脑血管病(CVD)，占全部脑卒中的80%，致残率和死亡率高，是威胁人们健康的主要疾病。对CI发病机制和有效治疗的探索一直是研究热点。随着肽能神经对脑血管的支配被证实，肽能神经递质，尤其降钙素基因相关肽（CGRP）和内皮素(ET)与脑梗死的关系倍受重视，使肽类药物的应用成为治疗脑梗死的新方法。目的：观察肌氨肽苷治疗脑梗死的临床疗效。方法：将78名入选患者随机分2组：肌氨肽苷治疗组38例，碟脉灵对照组40例。进行神经功能评分及疗效评定、放免法测定血浆CGRP、ET的浓度及常规实验室检查，并进行安全性评价和统计学分析。结果：入选患者中有3例退出，治疗组神经功能缺损改善的总有效率和显效率为：75.0%、58.3%；对照组为59.0%、43.6%；两组比较肌氨肽苷治疗组总有效率高于对照组(Ｐ<0.05)，但显效率两组间差异无显著性。治疗组血浆CGRP浓度高于对照组，ET浓度低于对照组，且治疗组对血压的调节优于对照组。治疗组有2例首次用药时出现面部潮红、头胀，减慢静电速度后缓解，未见严重不良反应。 <WP=27>　　结论：肌氨肽苷通过调节脑梗死患者血浆CGRP、ET水平发挥治疗作用，疗效确定，安全性好，给药方便，尤其适用于高血压脑梗死的轻、中度患者，值得在临床推广。更多还原

【Abstract】 Cerebral infarction is the most common cerebrovascular disease，accounting for 80% of the strokes. Its mortality and the rate of handicap is all relatively high. Therefore, it’s the main threat to the people’s health. CI’s metabolism and therapy has been researched closely. Along with the peptides’ study in nervous system, CGRP and ET are attached importance to the relationship with CI. And this can offer a new way to treat the disease.Objective: To observe the clinic curative effect of muscular amino acids and nucleosides to treat cerebral infarction. Methods: To divide 78 patient hospitalized into 2 group at random: 38 patients in muscular amino acids and nucleosides group , 40 patients in Diemailing contrast group. Carry on neural function grade and curative effect evaluation, assay plasmal CGRP、ET density by RIA, and carry on comparison of routine inspection, security appraisal and statistics analysis. Results: There are 3 patients withdrawed. The medical damaged neural functional improvement’s general efficiency and remarkable efficiency respectively: 75.0%, 58.3%; Diemailing contrast group 59.0% , 43.6%. Two groups compared: Muscular amino acids and <WP=29>nucleosides is always more efficient than contrast group. Treat group’s plasmal CGRP density is higher than contrast group’s. And ET density is lower than it in contrast group. The treat group’s regulation to the blood pressure is superior to the contrast group. In treat group, 2 example appeared flush、top-heavy when using the medicine for the first time. Alleviate after slow down the dropping speed. No serious side-effect appeared. Conclusions: Muscular amino acids and nucleosides can regulate cerebral infarction patients’ plasmal CGRP、ET concentration to treat the disease. Muscular amino acids and nucleosides’curative effect is certain to treat the disease. It is proved that the medicine has few side-effects and can be given conveniently. It’s worth popularizing clinically in treating hypertension cerebral infarction, especially to the light and medium patients.更多还原