尤瑞克林治疗脑梗死后大脑中动脉侧支循环形成与预后的相关性研究(1)

http://www.100md.com 2017年2月12日 《医学信息》 2017年第6期

     摘要：目的 探讨尤瑞克林治疗急性脑梗死后大脑中动脉侧支循环形成与预后的相关性。方法 选择尤瑞克林治疗的大脑中动脉脑梗死患者50例，均予以缺血性脑卒中基础治疗、常规神经营养药以及尤瑞克林静脉注射治疗。患者经连续治疗2 w后通过TCD检测其侧支循环情况。根据检测结果将仅有大脑前动脉(ACA)代偿，仅有大脑后动脉(PCA)代偿，大脑前、后动脉联合代偿及无代偿的患者为四组，评价上述四组患者的临床疗效，对比治疗前后四组患者的NIHSS评分及mRS评分。结果 尤瑞克林治疗后，TCD检测发现仅大脑前动脉(ACA)代偿患者有22例，仅大脑后动脉(PCA)代偿的患者9例，大脑前、后动脉同时代偿的患者16例，无代偿的患者3例，大脑前后动脉同时代偿组NIHSS评分、mRS评分及临床症状的改善水平均显著优于其他三组(P<0.05)；ACA组较PCA组预后好(P>0.05)；PCA组与无代偿组相比，其预后无明显差异(P>0.05)。结论 急性脑梗死患者经尤瑞克林治疗后，大脑中动脉侧支循环形成良好者较侧枝循环形成差者预后好。

    关键词：TCD；尤瑞克林；大脑中动脉；侧支循环
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    Abstract：Objective To investigate the formation of Yuri Klein artery collateral circulation and prognosis in treatment of acute cerebral infarction after brain.Methods Yuri Klein treatment of middle cerebral artery in patients with cerebral infarction in 50 cases，were treated with basic treatment of ischemic stroke，conventional neurotrophic drugs and Yuri Klein with continuous intravenous injection.After 2 w treatment was detected by TCD the collateral circulation.According to the results of the test will be only the anterior cerebral artery(ACA)compensation，only the posterior cerebral artery (PCA)compensation，anterior cerebral artery after combined，patients with and without compensatory compensation into four groups，evaluate the clinical curative effect of the four groups，four groups of patients with NIHSS score and mRS score were compared before and after Yuri Klein treatment. Results After treatment，TCD detected only the anterior cerebral artery (ACA) group with 22 cases，only the posterior cerebral artery (PCA) in 9 cases， the patients with compensatory anterior cerebral artery，after the same 16 cases of compensatory patients，3 cases of uncompensated patients before and after cerebral artery and compensatory group NIHSS score，mRS score and clinical symptoms improved significantly better than the other three groups (P<0.05)；ACA group was better than PCA group(P>0.05)；there was no significant difference in the prognosis between PCA group and unpublished group(P> 0.05)Conclusion The patients with acute cerebral infarction after Yuri Klein treatment，the middle cerebral artery collateral circulation is better than the collateral circulation of poor prognosis is good.
, 百拇医药
    Key words：TCD；Yuri Klein；Middle cerebral artery；Collateral circulation

    大腦中动脉(MCA)闭塞或狭窄是缺血性脑血管疾病最常见的病因，急性脑梗死后神经缺损的严重程度与大脑中动脉侧支循环建立的早晚及好坏密切相关[1]。研究发现，尤瑞克林具有促进新生血管形成、调节血管舒缩、抑制炎症反应及细胞凋亡等作用，在急性脑梗死的治疗中受到人们的广泛关注。前期研究中，急性脑梗死患者经尤瑞克林治疗后，TCD 检测发现治疗后患者的大脑中动脉血流流速均提高、血管顺应性均下降，说明按疗程应用尤瑞克林可改善血供。因此，本研究将在此基础上利用TCD对经尤瑞克林治疗的MCA狭窄或闭塞进行评估，以更好地为患者的病情评估、治疗方案提供良好的依据。, 百拇医药(康成 邓惠慧 宁晓明 吴子强 李泳祺)

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