高壓氧聯合依達拉奉和奧扎格雷鈉治療進展性腦梗死的近期療效觀察_《中國循證醫學雜志》

作者：

 陳伏萍 , 于興旭

遼寧醫學院附屬第一醫院神經內科（錦州 121000）;

關鍵詞：

進展性腦梗死高壓氧依達拉奉奧扎格雷鈉隨機對照試驗

DOI：

10.7507/1672-2531.20130070

視頻：

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目的　觀察高壓氧聯合依達拉奉和奧扎格雷鈉治療進展性腦梗死的近期療效和安全性。
方法　將進展性腦梗死患者65例按入院先后分為試驗組（高壓氧聯合依達拉奉和奧扎格雷鈉，33例）和對照組（依達拉奉聯合奧扎格雷鈉，32例），治療14天，并在治療前、后分別評價神經功能缺損程度（NIHSS）、日常生活活動能力（ADL）和臨床療效。
結果　試驗組患者NIHSS、ADL評分均較對照組有顯著改善，兩組差異均有統計學意義（P lt;0.05）；試驗組臨床有效率達90.91%，明顯高于對照組，兩組差異有統計學意義（P=0.028）。兩組均未見嚴重不良反應發生。
結論　高壓氧聯合依達拉奉和奧扎格雷鈉治療進展性腦梗死近期療效顯著，安全性好，具有一定的臨床推廣價值。

引用本文： 陳伏萍,于興旭. 高壓氧聯合依達拉奉和奧扎格雷鈉治療進展性腦梗死的近期療效觀察. 中國循證醫學雜志, 2013, 13(4): 413-416. doi: 10.7507/1672-2531.20130070 復制

1.	Israeli-korn SD, Schwammenthal Y, Yonash-Kimchi T, et al. Ischemic stroke duc to acute basilar artery occlusion: proportion and outcomes. Isr Med Assoc J, 2010, 12(11): 671-675.
2.	Jensen JK, Hallen J, Lund T, et al. Troponin I degradation in serum of patients with acute ischemic stroke. Scand J Clin Lab Invest, 2011, 71(1): 74-80.
3.	Sung SF, Ong CT, Wu CS, et al. Increased use of thrombolytic therapy and shorte ning of in-hospital delays following acute ischemic stroke: experience on the establishment of a primary stroke center at a comunity hospital. Acta Neurol Taiwan, 2010, 19(4): 24-252.
4.	朱曉鶯, 邱有波, 楊拯. 奧扎格雷鈉聯合依達拉奉治療腦梗死的系統評價. 中國循證醫學雜志, 2011, 11(8): 932-939.
5.	李紹發, 梁柯. 依達拉奉聯合早期高壓氧療對急性缺血性卒中的療效觀察. 中國實用神經疾病雜志, 2010, 13(22): 77-78.
6.	中華神經科學會. 各類腦血管疾病診斷要點. 中華神經科雜志, 1996, 29(9): 379-38.
7.	陳清棠. 腦卒中患者臨床神經功能缺損程度評分標準及臨床療效評定標準. 中華神經科雜志, 1996, 29(9): 381-383.
8.	MeCann SK, Dusting GJ, Roulston CL. Early increase of Nox4 NADPH ox idase and super ox ide generation following endothelin-1-induced stroke in conscious rats. J Neurosci Res, 2008, 86(11): 2524-2534．.
9.	Terao Y, Ohta H, Oda A, et al. Macrophage inflammatory protein-3 alpha plays a key role in the inflammatory cascade in rat focal cerebral ischemia. Neurosci Res, 2009, 64(1): 75-82.
10.	Dai HB, Fu QL, Shen Y, et al. The histamine H3 receptor antagonist clobenprop it enhances GABA release to protect against NMDA-induced excitotoxieity through the cAMP/protein kinase A pathway in cultured cortical neurons. Eur J Pharmacol, 2007, 563(3): 117-123.
11.	Rafferty M, Walters MR, Dawson J. Anti-Platelet therapy and aspirin resistance clinically and chemically relevant?. Curr Med Chem, 2010, 17(36): 4578-4586.
12.	Vizioli L, Muscari S, Muscari A. The relationship of mean platelet volume with the risk and prognosis of cardiovascular diseases. Int J Clin Pract, 2009, 63(10): 1509-1515.
13.	Ansara AJ, Nisly SA, Arif SA, et al. Aspirin dosing for the prevention and treatment of isehemic stroke:an indication-specific review of the literature. Ann Pharma-cother, 2010, 44(5): 851-862.
14.	Nishi H, Watanabe T, Sakurai H, et al. Effect of MCI-186 on brain edema in rats. Stroke, 2001, 20: 1236-1240.
15.	Edaravone Acute Infaretion Study Group. Effect of a novel free radical scanenger edaravone (MCI-186). On acute brain irrfaretion, Randomized Iacebo-controlled, study at multicenters. Cerebrovase Dis, 2003, 15(3): 222-229.
16.	蔣明勇, 何舉名, 王漢蛟. 依達拉奉聯合醒腦靜治療成人急性腦梗死療效的系統評價. 中國循證醫學雜志, 2012, 12(11): 1339-1346.
17.	Zhu HP, Liu YZ, Liu L. Correlation of high—sensitivity C-reactive protein and carotid plaque in patients with acute cerebral infarction. Journal of Clinical Neurology, 2007, 20(4): 298.
18.	Tanahashi N. Antithrombotic therapy in cerebral infaction. Rinsho Shinkei- gaku, 2000, 40(12): 1251-1253.
19.	羅文芳, 易振佳, 李密, 等. 高壓氧對顱腦損傷患者血液流變學的影響. 現代生物醫學進展, 2008, 8(5): 892-894.
20.	Veltkamp R, Wamer DS, Domoki F, et al. Hyperbaric oxygen decreases infarct size and behavioral deficit after transient focal cerebral ischemia in rats. Brain Res, 2003, 853(1): 68-73.
21.	Tighe SQ, Nelson RA. Hyperbaric oxygen therapy. Br J Anaesth, 2000, 85(4): 656-657.

1. Israeli-korn SD, Schwammenthal Y, Yonash-Kimchi T, et al. Ischemic stroke duc to acute basilar artery occlusion: proportion and outcomes. Isr Med Assoc J, 2010, 12(11): 671-675.
2. Jensen JK, Hallen J, Lund T, et al. Troponin I degradation in serum of patients with acute ischemic stroke. Scand J Clin Lab Invest, 2011, 71(1): 74-80.
3. Sung SF, Ong CT, Wu CS, et al. Increased use of thrombolytic therapy and shorte ning of in-hospital delays following acute ischemic stroke: experience on the establishment of a primary stroke center at a comunity hospital. Acta Neurol Taiwan, 2010, 19(4): 24-252.
4. 朱曉鶯, 邱有波, 楊拯. 奧扎格雷鈉聯合依達拉奉治療腦梗死的系統評價. 中國循證醫學雜志, 2011, 11(8): 932-939.
5. 李紹發, 梁柯. 依達拉奉聯合早期高壓氧療對急性缺血性卒中的療效觀察. 中國實用神經疾病雜志, 2010, 13(22): 77-78.
6. 中華神經科學會. 各類腦血管疾病診斷要點. 中華神經科雜志, 1996, 29(9): 379-38.
7. 陳清棠. 腦卒中患者臨床神經功能缺損程度評分標準及臨床療效評定標準. 中華神經科雜志, 1996, 29(9): 381-383.
8. MeCann SK, Dusting GJ, Roulston CL. Early increase of Nox4 NADPH ox idase and super ox ide generation following endothelin-1-induced stroke in conscious rats. J Neurosci Res, 2008, 86(11): 2524-2534．.
9. Terao Y, Ohta H, Oda A, et al. Macrophage inflammatory protein-3 alpha plays a key role in the inflammatory cascade in rat focal cerebral ischemia. Neurosci Res, 2009, 64(1): 75-82.
10. Dai HB, Fu QL, Shen Y, et al. The histamine H3 receptor antagonist clobenprop it enhances GABA release to protect against NMDA-induced excitotoxieity through the cAMP/protein kinase A pathway in cultured cortical neurons. Eur J Pharmacol, 2007, 563(3): 117-123.
11. Rafferty M, Walters MR, Dawson J. Anti-Platelet therapy and aspirin resistance clinically and chemically relevant?. Curr Med Chem, 2010, 17(36): 4578-4586.
12. Vizioli L, Muscari S, Muscari A. The relationship of mean platelet volume with the risk and prognosis of cardiovascular diseases. Int J Clin Pract, 2009, 63(10): 1509-1515.
13. Ansara AJ, Nisly SA, Arif SA, et al. Aspirin dosing for the prevention and treatment of isehemic stroke:an indication-specific review of the literature. Ann Pharma-cother, 2010, 44(5): 851-862.
14. Nishi H, Watanabe T, Sakurai H, et al. Effect of MCI-186 on brain edema in rats. Stroke, 2001, 20: 1236-1240.
15. Edaravone Acute Infaretion Study Group. Effect of a novel free radical scanenger edaravone (MCI-186). On acute brain irrfaretion, Randomized Iacebo-controlled, study at multicenters. Cerebrovase Dis, 2003, 15(3): 222-229.
16. 蔣明勇, 何舉名, 王漢蛟. 依達拉奉聯合醒腦靜治療成人急性腦梗死療效的系統評價. 中國循證醫學雜志, 2012, 12(11): 1339-1346.
17. Zhu HP, Liu YZ, Liu L. Correlation of high—sensitivity C-reactive protein and carotid plaque in patients with acute cerebral infarction. Journal of Clinical Neurology, 2007, 20(4): 298.
18. Tanahashi N. Antithrombotic therapy in cerebral infaction. Rinsho Shinkei- gaku, 2000, 40(12): 1251-1253.
19. 羅文芳, 易振佳, 李密, 等. 高壓氧對顱腦損傷患者血液流變學的影響. 現代生物醫學進展, 2008, 8(5): 892-894.
20. Veltkamp R, Wamer DS, Domoki F, et al. Hyperbaric oxygen decreases infarct size and behavioral deficit after transient focal cerebral ischemia in rats. Brain Res, 2003, 853(1): 68-73.
21. Tighe SQ, Nelson RA. Hyperbaric oxygen therapy. Br J Anaesth, 2000, 85(4): 656-657.

《中國循證醫學雜志》

高壓氧聯合依達拉奉和奧扎格雷鈉治療進展性腦梗死的近期療效觀察

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《中國循證醫學雜志》

高壓氧聯合依達拉奉和奧扎格雷鈉治療進展性腦梗死的近期療效觀察

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