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目的探讨体外超声波联合低分子肝素钙治疗脑梗死的疗效及其血浆溶血磷脂酸(LPA)水平的改变。方法 110例脑梗死患者随机分为联合治疗组(n=60)和对照组(n=50)。两组患者均给予低分子肝素钙5000 U皮下注射,每天2次;疏血通6 ml加入生理盐水250 ml静脉滴注,每天1次;连续14 d。联合治疗组同时加用体外(头部)超声波治疗,每天2次,连续14 d。在治疗前及治疗后进行神经功能缺损程度评分(NDS),以及用复合磷定法检测血浆LPA含量。根据患者治疗后NDS的改变评定疗效。结果两组治疗后的NDS和血浆LPA水平均比治疗前显著降低(P<0.05~0.01),而联合治疗组治疗后的NDS和血浆LPA水平又均显著低于对照组(P<0.05~0.01)。联合治疗组的显效率(55%)和总有效率(91.6%)均明显高于对照组(36%,70%)(P<0.05~0.01)。结论超声波联合低分子肝素治疗脑梗死有显著的效果;其机制可能与联合治疗能抑制LPA的释放,降低血浆LPA水平有关。
Objective To investigate the therapeutic effect of extracorporeal ultrasound combined with low molecular weight heparin on cerebral infarction and the changes of plasma lysophosphatidic acid (LPA) level. Methods A total of 110 patients with cerebral infarction were randomly divided into combined treatment group (n = 60) and control group (n = 50). Two groups of patients were given low molecular weight heparin 5000U subcutaneous injection, 2 times a day; Shuxuetong 6 ml 250 ml normal saline intravenously once a day for 14 days. The combination therapy group plus external (head) ultrasound treatment, 2 times a day for 14 days. Neurological deficit scores (NDS) were measured before and after treatment, and plasma LPA levels were measured by complex phosphorus assay. According to the patient after treatment to assess the change of NDS efficacy. Results The levels of NDS and LPA in both groups after treatment were significantly lower than those before treatment (P <0.05-0.01), while the levels of NDS and LPA in the combined treatment group were significantly lower than those in the control group (P <0.05-0.01 ). The combined therapy group was significantly higher effective rate (55%) and total effective rate (91.6%) than the control group (36%, 70%) (P <0.05 ~ 0.01). Conclusion Ultrasound combined with low molecular weight heparin in the treatment of cerebral infarction has a significant effect; its mechanism may be associated with inhibition of LPA release, reduce plasma LPA levels.