摘要
目的研究依达拉奉对急性脑梗死超时间窗(>6小时)溶栓患者的神经保护作用。方法选择发病6～12小时内完成核磁共振灌注成像(PWI)、核磁共振弥散成像(DWI)检查且PWI>DWI的60例急性脑梗死患者,随机分为溶栓组(A组)、溶栓+依达拉奉治疗组(B组)和对照组(C组)3组,A组、B组均给予重组组织型纤溶酶原激活剂(rt-PA)0.6～0.9mg/kg静脉滴注溶栓治疗,C组常规治疗。3组患者在溶栓前、溶栓后1周、2周、3个月分别行美国国立卫生院卒中量表(NIHSS)评分,及日常生活能力量表(ADL)评分。结果B组在溶栓后1周、2周、3个月的NIHSS评分分别为7.43±3.32、6.71±3.26和4.08±2.13,均较A组、C组降低(P<0.05);溶栓后2周、3个月的ADL评分分别为67.23±13.72和81.54±12.21,较A组、C组明显升高(P<0.05);B组治疗后复查头颅CT梗死面积小于A组和C组;3组均无严重不良反应。结论在PWI>DWI影像学模式指导下,将依达拉奉和rt-PA联合应用可适当延长急性缺血性卒中的溶栓时间窗。
Objective To study the neuroprotective efficacy of edaravone beyond the time window（6 h） in patients with acute cerebral infarcts.Methods Sixty patients with acute cerebral infarcts which were imaged with PWI and DWI（PWIDWI） within 6-12 hours after symptom onset were divided into thrombolytic group（group A）,thrombolysis＋ edaravone group（group B） and control group（group C） randomly.The patients of group A and group B were treated with intravenous human tissue-type plasminogen activator（rt-PA） 0.6-0.9 mg/kg,group C received common therapy.The three groups were scored with NIHSS/ADL respectively at pre-thrombolysis,1 week,2 weeks and 3 months after thrombolysis.Results The NIHSS scores of group B were 7.43±3.32,6.71±3.26 and 4.08±2.13 respectively at 1 week,2 weeks and 3 months after thrombolysis,which were lower than those of group A or C （P0.05）,the NIHSS scores of the ADL score of group B were 67.23±13.72 and 81.54±12.21 respectively at 2 weeks and 3 months after thrombolysis,which were higher than those of group A or C significantly（P0.05）.The beneficial effect was observed in the focus size on CT with edaravone therapy in broadened therapeutic window.There were no serious cranial bleeding cases on three therapy groups.Conclusion Guided by PWIDWI image,the therapy of edaravone combined with rt-PA might extend the time window for thrombolytic treatment of acute ischemic stroke.
出处
《临床荟萃》
CAS
2009年第24期2131-2134,共4页
Clinical Focus
关键词
脑梗塞
纤溶酶原激活剂
时间因素
神经保护作用
brian infarction
plasminogen activator
time factors
neuroprotective agents
