醒脑静联合纳洛酮对急性脑出血伴意识障碍患者神经功能、炎性因子和氧化应激的影响

摘要 目的：探讨纳洛酮联合醒脑静对急性脑出血（ACH）伴意识障碍患者炎性因子、神经功能和氧化应激的影响。方法：选取2017年2月~2019年12月期间我院收治的95例ACH伴意识障碍患者,按照随机数字表法将上述患者分为对照组（n=47）和研究组（n=48）,对照组患者予以纳洛酮治疗,研究组则在对照组的基础上联合醒脑静治疗,比较两组患者疗效、神经功能、炎性因子和氧化应激指标,记录两组不良反应发生情况。结果：研究组治疗10 d后的临床总有效率为91.67%（44/48）,高于对照组的74.47%（35/47）（P<0.05）。两组治疗10 d后美国国立卫生研究院卒中量表（NIHSS）评分,白介素-6（IL-6）、C反应蛋白（CRP）以及肿瘤坏死因子-α（TNF-α）、丙二醛（MDA）水平均较治疗前下降,且研究组低于对照组（P<0.05）。两组治疗10 d后超氧歧化酶 (SOD)水平均较治疗前升高,且研究组高于对照组（P<0.05）。两组不良反应发生率对比未见统计学差异（P>0.05）。结论：醒脑静联合纳洛酮治疗ACH伴意识障碍患者,疗效显著,可有效改善患者神经功能、炎性因子和氧化应激,且安全性较好。     

Tannuaspis,Tuvaspis and Ilemoraspis,endemic osteostracan genera from the Silurian and Devonian of Tuva and Khakassia (USSR)

Three osteostracan genera, Tannuaspis, Tuvaspis and Ilemoraspis, from the Silurian and Devonian of the Autonomous Republic of Tuva and the Autonomous Region of Khakassia (USSR), are revised on the basis of the type material briefly described by Obruchev (1956, 1961, 1964). Tannuaspis bears some resemblances with the Tremataspididae. Tuvaspis may be closely related to Tannuaspis. Finally, there is no evidence of paired fins and cornual processes in Ilemoraspis (neither is there any evidence of their absence). Tannuaspis and Ilemoraspis share some characters which are not found in any other osteostracan: widely separated orbits, very small and oval lateral fields, situated at the same level as the median dorsal field. These resemblances may suggest that these two genera (to which Tuvaspis may be added) form a monophyletic group of osteostracans, which may be endemic to this part of Central Asia.