注射用丹参多酚酸治疗急性大动脉粥样硬化型脑梗死的疗效
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摘要
目的评价注射用丹参多酚酸对急性大动脉粥样硬化型脑梗死患者的临床疗效及安全性。方法收集2016年9月—2017年8月山西医科大学第一医院收治的急性脑梗死患者100例,随机分为对照组及观察组,各50例。对照组予常规治疗,观察组在对照组基础上加用注射用丹参多酚酸,每次0.13 g加入250 mL 0.9%氯化钠中静滴,1次/d,治疗周期均为14 d。比较两组患者治疗前和治疗后神经功能缺损(NIHSS)评分、Barthel指数(BI)评分、血纤维蛋白原(FIB)、肝肾功能、心肌酶的变化以及不良反应。结果治疗后,两组的NIHSS评分和BI评分均有显著改善(P<0.05),且观察组NIHSS评分低于对照组(P<0.05),BI评分高于对照组(P<0.05);观察组血FIB与治疗前比较具有统计学差异(P<0.05)。两组患者用药前后肝肾功能、心肌酶未见明显变化,用药过程中无不良事件发生。结论注射用丹参多酚酸可以改善急性大动脉粥样硬化型脑梗死患者的NIHSS评分和BI评分,并能在一定程度上降低血FIB水平;对患者的肝功能、肾功能、心肌酶等无明显影响,副作用小。
Objective To evaluate the clinical effect and safety of Salvianolic Acids for Injection(SAFI) in treatment of acute aortic atherosclerotic cerebral infarction. Methods A total of 100 patients of acute aortic atherosclerotic cerebral infarction in The First Hosipital of Shanxi Medical University from September 2016 to August 2017 were selected and were randomly divided into the observation group and the control group. The patients in the control group received routine medicine therapy, and the patients in the treatment group received SAFI 0.13 g added for 0.9% sodium chloride 250 mL intravenous drip qd in addition to the treatment of control group. Patients treated once per day and 14 d for one course of treatment, and the prognosis of the two groups were observed by NIHSS scores and BI scores, fibrinogen(FIB), liver and kidney function, myocardial enzymes and incidence of adverse reactions.Results After treatment, the NIHSS score and BI score in both groups were significantly improved(P < 0.05), and the NIHSS score in the observation group was lower than that in the control group(P < 0.05), and the BI score was higher than that in the control group(P < 0.05). The FIB of blood in the experimental group was significantly different from that before treatment(P < 0.05). The liver and kidney functions and myocardial enzymes of the two groups did not change significantly before and after treatment, and no adverse events occurred during the medication process. Conclusion SAFI can improve NIHSS scores and BI scores of patients with acute atherosclerotic cerebral infarction, and reduce blood FIB level to a certain extent. Additionally, it has no obvious effect on liver function, kidney function and myocardial enzyme, and has little side effect.
Objective To evaluate the clinical effect and safety of Salvianolic Acids for Injection(SAFI) in treatment of acute aortic atherosclerotic cerebral infarction. Methods A total of 100 patients of acute aortic atherosclerotic cerebral infarction in The First Hosipital of Shanxi Medical University from September 2016 to August 2017 were selected and were randomly divided into the observation group and the control group. The patients in the control group received routine medicine therapy, and the patients in the treatment group received SAFI 0.13 g added for 0.9% sodium chloride 250 mL intravenous drip qd in addition to the treatment of control group. Patients treated once per day and 14 d for one course of treatment, and the prognosis of the two groups were observed by NIHSS scores and BI scores, fibrinogen(FIB), liver and kidney function, myocardial enzymes and incidence of adverse reactions.Results After treatment, the NIHSS score and BI score in both groups were significantly improved(P < 0.05), and the NIHSS score in the observation group was lower than that in the control group(P < 0.05), and the BI score was higher than that in the control group(P < 0.05). The FIB of blood in the experimental group was significantly different from that before treatment(P < 0.05). The liver and kidney functions and myocardial enzymes of the two groups did not change significantly before and after treatment, and no adverse events occurred during the medication process. Conclusion SAFI can improve NIHSS scores and BI scores of patients with acute atherosclerotic cerebral infarction, and reduce blood FIB level to a certain extent. Additionally, it has no obvious effect on liver function, kidney function and myocardial enzyme, and has little side effect.
引文
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[12]蒋玉凤,王秋华,刘智勤,等.丹酚酸B对脑缺血小鼠脑能荷和三磷酸腺苷酶活性的影响[J].中国中药杂志,2007, 32(18):1903-1906.
[13]杜冠华,陈永红,张均田.丹酚酸B对局灶性脑缺血再灌注所致线粒体损伤的保护作用[A]//中国药理学会第八次全国代表大会论文摘要汇编[C].上海:2002.
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[15] Xu S, Zhong A, Ma H, et al. Neuroprotective effect of salvianolic acid B against cerebral ischemic injury in rats via the CD40/NF-κB pathway associated with suppression of platelets activation and neuroinflammation[J]. Brain Res, 2017, 1661:37-48.
[16]胡湘蜀,黄娟,周东.脑血管病的病理及病生研究进展与临床第五节纤维蛋白原与动脉硬化和脑卒中[J].中华医学信息导报, 2002, 17(23):21-22.
[17]郝彦超,苏建.丹参多酚酸对脑梗死患者血液流变学和神经功能的影响[J].中国实用神经疾病杂志, 2014(16):67-68.
[18]高颖,周莉,尹平,等. 3430例观察注射用丹参多酚酸冻干粉上市后临床应用安全性[J].中风与神经疾病杂志, 2015, 32(5):427-429.
[2]裴媛,周贺伟.丹参多酚酸治疗脑梗死的疗效与安全性[J].中国医院用药评价与分析, 2017, 17(2):202-203, 206.
[3]田介峰,阎红,王瑞静,等.丹参多酚酸提取物化学成分的分离与鉴定[J].中草药, 2018, 49(21):5024-5028..
[4] Han J Y, Fan J Y, Horie Y, et al. Ameliorating effects of compounds derived from Salvia miltiorrhiza root extract on microcirculatory disturbance and target organ injury by ischemia and reperfusion[J]. Pharmacol Ther, 2007,117(2). DOI:10.1016/j.pharmthera.2007.09.008.
[5]周衡,王拥军,王素香,等.急性缺血性脑卒中的TOAST亚型分析[J].中华内科杂志, 2004, 43(7):495-498.
[6]中华神经科学会.各类脑血管疾病诊断要点[J].中华神经科杂志, 1996, 29(6):379.
[7] Gao S, Wang Y J, Xu A D, et al. Chinese ischemic stroke subclassification[J]. Front Neurol, 2011(2):6. DOI:10.3389/fneur.2011.00006.
[8] Goldstein L B, Bertels C, Davis J N. Interrater reliability of the NIH stroke scale[J]. Archiv Neurol, 1989, 46(6):660.
[9] Wade D T, Collin C. The Barthel ADL Index:A standard measure of physical disability?[J]. Int Rehabil Med,1988, 10(2):4.
[10]金惠铭,王建枝.病理生理学[M].第7版.北京:人民卫生出版社, 2010:78-79.
[11]蒋玉凤,王秋华,刘智勤,等.丹酚酸B对缺血小鼠脑能量代谢和脑水肿的影响[J].中国病理生理杂志, 2007,23(12):2300-2303.
[12]蒋玉凤,王秋华,刘智勤,等.丹酚酸B对脑缺血小鼠脑能荷和三磷酸腺苷酶活性的影响[J].中国中药杂志,2007, 32(18):1903-1906.
[13]杜冠华,陈永红,张均田.丹酚酸B对局灶性脑缺血再灌注所致线粒体损伤的保护作用[A]//中国药理学会第八次全国代表大会论文摘要汇编[C].上海:2002.
[14]任德成,杜冠华,张均田.总丹酚酸对脑缺血再灌注损伤的保护作用[J].中国药理学通报, 2002, 18(3):275-277.
[15] Xu S, Zhong A, Ma H, et al. Neuroprotective effect of salvianolic acid B against cerebral ischemic injury in rats via the CD40/NF-κB pathway associated with suppression of platelets activation and neuroinflammation[J]. Brain Res, 2017, 1661:37-48.
[16]胡湘蜀,黄娟,周东.脑血管病的病理及病生研究进展与临床第五节纤维蛋白原与动脉硬化和脑卒中[J].中华医学信息导报, 2002, 17(23):21-22.
[17]郝彦超,苏建.丹参多酚酸对脑梗死患者血液流变学和神经功能的影响[J].中国实用神经疾病杂志, 2014(16):67-68.
[18]高颖,周莉,尹平,等. 3430例观察注射用丹参多酚酸冻干粉上市后临床应用安全性[J].中风与神经疾病杂志, 2015, 32(5):427-429.