CAJ | 학술논문

目的评价脱氧核苷酸注射液治疗急性脑梗死的有效性和安全性.方法本研究采用多中心、随机单盲对照的方法,于2013年5月至2014年5月共入选144例脑梗死患者,随机分为对照组和治疗组,对照组(n=72)病人给予溶栓、抗凝、抗血小板、活血化瘀等方法进行治疗,治疗组(n=72)在对照组基础上给予脱氧核苷酸注射液(200 mg/d),连续21 d,评价患者的神经功能缺损状况并检测血清蛋白含量,记录医院感染发生情况.结果治疗后,两组美国国立卫生院神经功能缺损评分(national institutes of health neurological function,NIHSS)均显著下降、日常生活活动评分(Barthel指数)均明显提高,但治疗组NIHSS评分下降以及Barthel指数提高更显著(P＜0.05).治疗组与对照组在基本痊愈率(26.0％ vs 10.3％)、总有效率(91.3％ vs 73.5％)方面比较差异有统计学意义(P＜0.05).血清蛋白检测显示,两组总蛋白(total protein,TP)、白蛋白(albumin,ALB)水平均显著下降,但治疗组TP、ALB水平下降程度显著低于对照组(P＜0.05).治疗21 d后,治疗组CD3+、CD4+、自然杀伤(natural killer,NK)细胞水平均显著高于对照组,而医院感染发生率显著低于对照组(P＜0.05).治疗期间两组除发生低热、皮疹、头痛、轻微恶心呕吐外,均未见其他严重不良反应.结论脱氧核苷酸注射液可改善急性脑梗死患者神经功能缺损状况,增加血清蛋白水平,增强机体免疫力,减少医院感染发生率,治疗过程基本无不良反应.
목적 평개탈양핵감산주사액치료급성뇌경사적유효성화안전성.방법 본연구채용다중심、수궤단맹대조적방법,우2013년5월지2014년5월공입선144례뇌경사환자,수궤분위대조조화치료조,대조조(n=72)병인급여용전、항응、항혈소판、활혈화어등방법진행치료,치료조(n=72)재대조조기출상급여탈양핵감산주사액(200 mg/d),련속21 d,평개환자적신경공능결손상황병검측혈청단백함량,기록의원감염발생정황.결과 치료후,량조미국국립위생원신경공능결손평분(national institutes of health neurological function,NIHSS)균현저하강、일상생활활동평분(Barthel지수)균명현제고,단치료조NIHSS평분하강이급Barthel지수제고경현저(P＜0.05).치료조여대조조재기본전유솔(26.0％ vs 10.3％)、총유효솔(91.3％ vs 73.5％)방면비교차이유통계학의의(P＜0.05).혈청단백검측현시,량조총단백(total protein,TP)、백단백(albumin,ALB)수평균현저하강,단치료조TP、ALB수평하강정도현저저우대조조(P＜0.05).치료21 d후,치료조CD3+、CD4+、자연살상(natural killer,NK)세포수평균현저고우대조조,이의원감염발생솔현저저우대조조(P＜0.05).치료기간량조제발생저열、피진、두통、경미악심구토외,균미견기타엄중불량반응.결론 탈양핵감산주사액가개선급성뇌경사환자신경공능결손상황,증가혈청단백수평,증강궤체면역력,감소의원감염발생솔,치료과정기본무불량반응.
Objective To evaluate the effectiveness and safety of deoxynucleotide injection in treatment of acute cerebral infarction.Methods Through a multicenter,randomized,single-blind controlled method,144 cases of cerebral infarction patients were enrolled in the control group (n=72) patients who received thrombolysis,anticoagulation,antiplatelet,blood circulation and other standard therapy.Experimental group (n=72) was given deoxynucleotide acid injection (200 mg/d) based on the control group therapy,for continuous 21 days,neurological deficit status of patients was evaluated and serum protein content was detected,and hospital infection rate was also recorded.Results NIHSS scores before and after treatment were significantly decreased in both groups,but the treatment group decreased more significantly compared with the control group (P ＜ 0.05).Barthel indexes before and after treatment were all significantly increased in both groups,but the control group improved more significantly (P ＜ 0.05).The basical recovered rates before and after treatment were 26.0％ and 10.3％,the total efficiency were 91.3％ and 73.5％ respectively,two groups showed statistical significant difference (P ＜ 0.05).Serum protein detection display,TP,ALB levels had decreased to some extent (P ＜ 0.05).After treatment,the TP,ALB levels of the treatment group dropped below the level of the control group,showing a statistical significant difference between the two groups (P ＜ 0.05).After treatment,the 21d,the treatment group CD3+,CD4+,NK cells levels were higher,with a significant difference between the two groups (P ＜ 0.05).Nosocomial infection rates of two groups were 2.9％ and 11.7％ respectively,with a statistical significant difference (x 2=3.979,P=0.046).Conclusion Deoxynucleotide injection can improve neurological impairment of patients,increase their serum protein levels,improve their immunocompetence,and reduce the incidence of nosocomial infection.And it substantially has no adverse reaction during treatment.