高压氧联合依达拉奉、奥扎格雷钠治疗急性脑梗死的疗效观察

目的：评价高压氧联合依达拉奉、奥扎格雷钠治疗急性脑梗死（ACI）的临床疗效，观察其对患者血液流变学指标与血浆血栓素A2（TXA2）、前列腺素I2（PGI2）水平的影响。方法：86例急性脑梗死患者随机分为治疗组与对照组：其中治疗组45例，应用高压氧联合依达拉奉、奥扎格雷钠进行治疗；对照组41例单用奥扎格雷钠，对比分析等两组治疗前后神经功能缺损评分（NHSS）、Barthel指数（BI）和血液流变学指标变化，同时采用放射免疫法检测患者治疗前后血浆TXA2和PGI2含量，最后比较两组患者的临床疗效。结果：①治疗组基本治愈率和总有效率分别为28．89％、91．11％，优于对照组17．07％的基本治疗愈率和80．49％的总有效率（P〈0．01），两组均无明显不良反应。②经过治疗，患者NHSS评分明显下降，而BI评分明显升高（P〈0．01或0．05），且治疗组改善程度高于对照组（P〈0．01或0．05）。（3）治疗后，患者各血液流变学指标均明显下降（P〈0．01或0．05），其中治疗组血小板凝集率、纤维蛋白原水平和血液粘稠度降低幅度大于对照组（P〈0．05）。④经过治疗，两组血浆TXA2水平下降，PGI2水平上升，TXA2／PGI2比值减少（P〈0．01），其中治疗组变化明显好于对照组（P〈0．01或0．05）。结论：高压氧联合依达拉奉、奥扎格雷钠治疗急性脑梗死能减轻脑细胞损伤，改善神经功能障碍，疗效显著，值得临床推广。

Hyperbaric Oxygen Combined with Edaravone and Sodium Ozagrel for Acute Cerebral Infraction

Objective： To evaluate the therapeutic effect of hyperbaric oxygen combined with edaravone and sodium ozagrel on patients with acute cerebral infarction （ACI）, observing their effect on hemorheology parameters, serum TXA2 and PGI2. Methods： A total of 86 patients with ACI were randomly divided into treatment group （45 cases） and control group （41 cases）. The control group was allocated with sodium ozagrel, and the treatment group was added with edaravone and hyperbaric oxygen. The therapeutic effect was elevated by NHSS, Barthel index and hemorheology parameters, and the changes of serum TXA2 and PGI2 were detected by immunoradiometric assay. Results ： （1）The basic heal rate and total effective rate were respectively 28.89% and 91.11% in treatment group, significantly higher than those control group （17.07% and 80.49%） （P〈0.01）, and there was no obvious adverse effects in both groups. （2） After treatment, NHSS significantly decreased in all patients, while BI significantly increased （P〈0.01 or 0.05）, and the neurological function was significantly improved in the treatment group as compared with the control group （P〈0.01 or 0.05）（3） The all hemorheology parameters were significantly down in all patients after treatment （P〈0.01 or 0.05）, and there was significance in percentage of platelet aggregation, levels of fibrinogen and whole blood shear viscosity between the treatment group and control group （P〈0.05）. （3） In both groups, the ratio of TXA2/PGI2 decreased after treatment owing to the decline of serum TXA2 and the increase of PGI2 （P〈0.01）, especially in the treatment group （P〈0.01 or 0.05）. Conclusion：Combination of hyperbaric oxygen, edaravone and sodium ozagrel is effective in reducing brain cells injure and improving the impaired neural function, thus worth being popularized in clinical treatment.