CAJ | 학술논문

目的探讨局部亚低温延长急性脑梗死治疗时间窗的临床效果.方法选取我院2013年4月至2014年1月收治的77例急性脑梗死患者作为研究对象,按治疗开始时间分为A组(≤6h)、B组(6～12 h)、C组(12～24 h)和D组(≥24 h),采用局部亚低温法进行治疗,比较四组在各时间段(入院时、治疗第7天、治疗第14天、治疗第30天)的NIHSS评分、血清NO含量以及SOD活力情况.结果四组患者在入院时的NIHSS评分情况经统计学检验,差异无统计学意义(P＞0.05),而在治疗后的第7、14、30天时四组NIHSS评分均明显下降,且在各时间段比较差异均有统计学意义(P＜0.05).各组患者在入院时血清NO情况比较,差异无统计学意义(P＞0.05),经治疗后均明显下降,四组患者在各时间段血清NO含量比较,差异均具有统计学意义(P＜0.05).入院时四组患者的血清SOD活力情况比较,差异无统计学意义(P＞0.05),经过治疗后均有一定程度上升,在各时间段比较,差异均具有统计学意义(P＜0.05).结论脑梗死患者采用局部亚低温进行治疗的最佳时间窗为发病6h内,6～24 h时间段的治疗效果随时间延长而降低,24 h后治疗效果不明显.
목적 탐토국부아저온연장급성뇌경사치료시간창적림상효과.방법 선취아원2013년4월지2014년1월수치적77례급성뇌경사환자작위연구대상,안치료개시시간분위A조(≤6h)、B조(6～12 h)、C조(12～24 h)화D조(≥24 h),채용국부아저온법진행치료,비교사조재각시간단(입원시、치료제7천、치료제14천、치료제30천)적NIHSS평분、혈청NO함량이급SOD활력정황.결과 사조환자재입원시적NIHSS평분정황경통계학검험,차이무통계학의의(P＞0.05),이재치료후적제7、14、30천시사조NIHSS평분균명현하강,차재각시간단비교차이균유통계학의의(P＜0.05).각조환자재입원시혈청NO정황비교,차이무통계학의의(P＞0.05),경치료후균명현하강,사조환자재각시간단혈청NO함량비교,차이균구유통계학의의(P＜0.05).입원시사조환자적혈청SOD활력정황비교,차이무통계학의의(P＞0.05),경과치료후균유일정정도상승,재각시간단비교,차이균구유통계학의의(P＜0.05).결론 뇌경사환자채용국부아저온진행치료적최가시간창위발병6h내,6～24 h시간단적치료효과수시간연장이강저,24 h후치료효과불명현.
Objective To investigate the clinical effect of local mild hypothermia for extending the therapeutic time window of acute cerebral infarction.Methods 77 patients with acute cerebral infarction admitted into our hospital from April 2013 to February 2014 were chosen as study objects and were divided into group A(≤ 6 h),group B (6 ～ 12 h),group C (12 ～ 24 h),and group D (≥ 24 h) according to when the treatment started,then all received local mild hypothermia treatment.The serum level of nitrogen monoxidum (No),the score of NIHSS and superoxide dismutase (SOD) of the four groups when admitted and day 7,14,and 30 of the treatment were compared.Results The NIHSS score had no statistical difference (P ＞ 0.05) between the four groups when admitted and markedly decreased in the four groups day 7,14,and 30,with statistical differences between different time periods (P ＜ 0.05).The serum level of NO and serum SOD activity had no statistical differences (P ＞ 0.05) between the four groups when admitted and the serum level of NO markedly decreased and the serum SOD activity markedly increased in the four groups day 7 and 14,with statistical differences between different time periods (P ＜ 0.05).Conclusions The best therapeutic time window of local mild hypothermia for patients with acute cerebral infarction is within 6 hours of onset; the treatment effect of 6 to 24 hour period decreases with time; and over 24 hours the effect is not obvious.