CAJ | 학술논문

目的：观察长春西汀联合丹参川芎嗪治疗脑梗死的疗效并分析其对血液流变学的影响。方法：脑梗死患者212例，随机分为对照组、联合治疗组，对照组口服阿托伐他汀＋肠溶拜阿司匹林并静脉滴注丹参川芎嗪注射液；联合治疗组在此治疗基础上静脉滴注长春西汀注射液20 mg；动态记录治疗前及治疗5 d、10 d、15 d、21 d 局部脑血流（rCBF）及脑电图（EEG）。测定治疗前及治疗3周后患者总胆固醇、低密度脂蛋白胆固醇、血沉、血液血小板集聚率、纤维蛋白原活性、全血高切黏度、全血底切黏度及红细胞压积等血液流变学指标，计算治疗前后卒中量表（NIHSS）及 Barthel 指数量表 ADL，并计算总有效率。结果：长春西汀联合丹参川芎嗪能显著降低血液血小板集聚率、纤维蛋白原活性、全血高切黏度、全血底切黏度，增加 rCBF 并恢复 EEG 至正常状态，NIHSS 评分明显下降，ADL 明显好转，总有效率达97％，与对照组比较，P ＜0．05，差异有统计学意义。结论：长春西汀联合丹参川芎嗪对脑梗死有理想的治疗作用。
목적：관찰장춘서정연합단삼천궁진치료뇌경사적료효병분석기대혈액류변학적영향。방법：뇌경사환자212례，수궤분위대조조、연합치료조，대조조구복아탁벌타정＋장용배아사필림병정맥적주단삼천궁진주사액；연합치료조재차치료기출상정맥적주장춘서정주사액20 mg；동태기록치료전급치료5 d、10 d、15 d、21 d 국부뇌혈류（rCBF）급뇌전도（EEG）。측정치료전급치료3주후환자총담고순、저밀도지단백담고순、혈침、혈액혈소판집취솔、섬유단백원활성、전혈고절점도、전혈저절점도급홍세포압적등혈액류변학지표，계산치료전후졸중량표（NIHSS）급 Barthel 지수량표 ADL，병계산총유효솔。결과：장춘서정연합단삼천궁진능현저강저혈액혈소판집취솔、섬유단백원활성、전혈고절점도、전혈저절점도，증가 rCBF 병회복 EEG 지정상상태，NIHSS 평분명현하강，ADL 명현호전，총유효솔체97％，여대조조비교，P ＜0．05，차이유통계학의의。결론：장춘서정연합단삼천궁진대뇌경사유이상적치료작용。
Objective:To observe the curative effect of vinpocetine combined with salvia ligustrazine in treating cerebral infarction and its influence on blood rheology.Methods:Two hundred and twelve cases of patients with cerebral infarction were randomly di-vided into control group and treatment group.Patients in the control group received oral atorvastatin and enteric coated aspirin and intravenous infusion of Danshen Ligustrazine Injection.Patients in the treatment group not only received the above treatment,but also were given 20 mg intravenous drip of vinpocetine injection;dynamic recorded before treatment and egional cerebral blood flow (rCBF)and electroencephalogram (EEG)on 5d,1 0d,1 5d,21 d after treatment.The levels of total cholesterol,low density lipo-protein cholesterol,ESR and blood platelet aggregation rate and fibrinogen activity,whole blood high shear viscosity,whole blood viscosity and bottom hematocrit and blood rheological index before and after the treatment,calculation of Stroke Scale (NIHSS) and Barthel index ADL were measured before and 3 weeks after treatment (W)in patients,and the total efficiency was calculated. Results:Vinpocetine combined with Danshen Ligustrazine could significantly reduce blood platelet aggregation rate and fibrinogen activity,whole blood high shear viscosity,whole blood viscosity increase bottom cut,rCBF and restore EEG to the normal state, the score of NIHSS decreased significantly,ADL was significantly improved,and the total effective rate was 97%,compared with the control group,P <0.05,there were significant significant differences.Conclusion:The therapeutic effect of vinpocetine com-bined with Danshen Ligustrazine on cerebral infarction is ideal.