【作者】 王欢；

【导师】 宋毅军；

【作者基本信息】 天津医科大学 ， 神经病学， 2020， 硕士

【摘要】 目的:探讨采取依达拉奉注射液联合丁苯酞注射液治疗急性缺血性脑卒中(AIS)的临床疗效、对患者血清炎症因子水平及抗氧化物的影响,旨在为临床医师提供有价值的参考与借鉴。方法:本课题选取本院2019年4月-2019年12月间收治的确诊为急性缺血性脑卒中的104例患者作为研究对象。采用随机数字表或者电脑盲选的方式将患者分成了实验组与对照组,每组各52例。对照组采取单纯的丁苯酞注射液治疗,实验组采取依达拉奉注射液联合丁苯酞注射液治疗。对两组患者经14d的治疗后的的临床疗效、治疗前后神经功能障碍评分(NIHSS评分)与日常生活能力评分(ADL)变化、治疗前后血清超敏C反应蛋白(hs-CRP)与超氧化物歧化酶(SOD)水平变化与治疗期间不良反应发生情况进行观察及对比。针对获取的研究结果使用SPSS21.0软件进行分析及组间对比,判断使用依达拉奉注射液联合丁苯酞注射液对急性缺血性脑卒中的治疗效果,进而为后续研究提供一定的准备工作。结果:1.经过14d的用药治疗,实验组患者的治疗总有效率为96.15%,对照组的治疗总有效率为84.62%。实验组治疗总有效率显著高于对照组,对比差异具有统计学意义(x~2=3.983,P<0.05)。2.治疗前实验组患者NIHSS评分为(22.26±1.56)分,对照组为(22.08±1.52)分,对比差异无统计学意义(t=0.596,P>0.05);治疗前实验组ADL评分为(50.26±4.56)分,对照组为(50.44±4.61)分,对比差异无统计学意义(t=0.200,P>0.05)。经14d的治疗对照组NIHSS评分为(7.25±0.86)分,明显低于对照组(11.26±1.21)分,对比差异有统计学意义(t=19.479,P<0.05);ADL评分实验组为(81.12±6.25)分,显著高于对照(72.21±5.41)分,对比差异有统计学意义(t=7.773,P<0.05)。3.治疗前实验组血清SOD水平为(162.25±14.52)U/L,对照组水平为(161.89±14.26)U/L,组间对比差异无统计学意义(t=0.128,P>0.05);治疗前实验组血清hs-CRP水平为(16.56±2.41)pg/ml,对照组水平为(16.42±2.38)pg/ml,组间对比差异无统计学意义(t=0.298,P>0.05)。经14d的对症治疗,实验组血清SOD为(388.25±29.56)U/L,对照组为(302.21±25.41)U/L,组间相比较差异有统计学意义(t=15.917,P<0.05);治疗后实验组血清hs-CRP为(8.33±1.46)pg/ml,对照组为(10.56±1.75)pg/ml,组间相比较差异具有统计学意义(t=7.056,P<0.05)。4.对症治疗期间实验组发生4例不良反应,总发生率为7.69%。对照组治疗期间发生5例不良反应,总发生率为9.62%。两组在不良反应总发生率上对比差异无统计学意义(x~2=0.122,P<0.05)。结论:对于急性缺血性脑卒中这一脑血管疾病,在临床治疗疾病中,采用依达拉奉注射液联合丁苯酞注射液的联合用药方案要比单纯使用丁苯酞注射液用药方案的效果好,主要联合用药治疗总有效率更高、更有效的改善神经功能障碍及提高日常生活能力、更显著提高血清SOD水平及降低血清hs-CRP水平、不增加用药期间的不良反应发生。更多还原

【Abstract】 Objective: To investigate the clinical efficacy of edaravone injection combined with butylphthalide injection in the treatment of acute ischemic stroke(AIS),and its effect on the serum levels of inflammatory factors and antioxidants in patients,so as to provide valuable references for clinicians.Methods: 104 patients with acute ischemic stroke admitted to our hospital from April 2019 to December 2019 were selected as the study subjects.The patients were divided into experimental group and control group by random number table or computer blind selection,with 52 cases in each group.The control group was treated with simple butylphthalide injection,and the experimental group was treated with edaravone injection and butylphthalide injection.On two groups of patients after treatment for 14 d of the clinical curative effect,nerve dysfunction score before and after the treatment ability score(NIHSS score)with daily life(ADL)change,before and after treatment serum hypersensitive c-reactive protein(hs-CRP)and superoxide dismutase(SOD)level change and the treatment of adverse reactions occurred during the observation and comparison.According to the obtained research results,SPSS21.0 software was used for analysis and comparison between groups to determine the therapeutic effect of edaravone injection combined with butylphthalide injection on acute ischemic stroke,so as to provide certain preparations for subsequent studies.Results: 1.After 14 d of drug treatment,the total effective rate of treatment of the experimental group was 96.15% and that of the control group was 84.62%.The total effective rate of the experimental group was significantly higher than that of the control group and the difference was statistically significant(x2=3.983,P < 0.05).2.Before treatment,NIHSS score of the experimental group was(22.26±1.56)while that of the control group was(22.08±1.52),without statistically significant difference(t=0.596,P > 0.05).Before treatment,ADL score of the experimental group was(50.26±4.56)points and that of the control group was(50.44±4.61)points without statistically significant difference(t=0.200,P > 0.05).NIHSS score of the treatment control group after 14 d was(7.25±0.86),which was significantly lower than that of the control group(11.26±1.21).The difference was statistically significant(t=19.479,P < 0.05).ADL score of the experimental group was(81.12±6.25),significantly higher than that of the control group(72.21±5.41)and the difference was statistically significant(t=7.773,P < 0.05).3.Before treatment,the serum SOD level of the experimental group was(162.25±14.52)U/L,while that of the control group was(161.89±14.26)U/L.There was no statistically significant difference between the groups(t=0.128,P > 0.05).Before treatment,the serum hs-crp level of the experimental group was(16.56±2.41)pg/ml,while that of the control group was(16.42±2.38)pg/ml.There was no statistically significant difference between the groups(t=0.298,P > 0.05).After 14 days of symptomatic treatment,the serum SOD of the experimental group was(388.25±29.56)U/L,and that of the control group was(302.21±25.41)U/L.The difference between the groups was statistically significant(t=15.917,P < 0.05).After treatment,the serum hs-crp of the experimental group was(8.33±1.46)pg/ml,while that of the control group was(10.56±1.75)pg/ml.The difference between the groups was statistically significant(t=7.056,P < 0.05).4.During symptomatic treatment,4 cases of adverse reactions occurred in the experimental group,with a total incidence of 7.69%.During treatment,5 cases of adverse reactions occurred in the control group,with a total incidence of 9.62%.There was no statistically significant difference in the total incidence of adverse reactions between the two groups(x2=0.122,P < 0.05).Conclusion: for the cerebrovascular disease,acute,ischemic cerebral stroke in clinical disease,using the adr in the combination of injection combined butyl phthalide injection solution than simply using butyl phthalide injection regimen of effect is good,the main combination treatment of total effective rate is higher,more effective improved nerve dysfunction,and improve the ability of daily life,and more significantly improve the level of serum SOD and lower serum hs CRP levels,no increase in adverse reactions occurred during medication.更多还原