三联药物方案对急性大面积脑梗死患者GCS评分、血红蛋白水平及不良反应的影响

摘要

目的 研究三联药物方案对急性大面积脑梗死患者GCS评分、血红蛋白水平及不良反应的影响.方法选择2015.1~2016.12在我院治疗的急性大面积脑梗死患者110例.随机分为对照组和实验组,每组各55例,对照组采用常规治疗,实验组加用依达拉奉+醒脑静+大株红景天三联药物方案.比较两组患者的疗效、GCS评分、血红蛋白水平及血流动力学指标等.结果实验组患者的总有效率为94.55%,高于对照组80.00%的总有效率(P<0.05).治疗后两组患者的NHISS评分、ADL评分和GCS评分均有所改善,实验组患者的NHISS评分低于对照组,ADL评分和GCS评分高于对照组(P<0.05).治疗后实验组患者的全血高切黏度、血浆黏度、纤维蛋白原和血细胞比容水平低于对照组(P<0.05).治疗后两组患者的血红蛋白、CRP和IL-8水平均有所改善,实验组患者的血红蛋白、CRP和IL-8水平低于对照组(P<0.05).结论急性大面积脑梗死患者采用依达拉奉+醒脑静+大株红景天三联药物方案治疗的疗效显著,可以改善患者的神经功能和血流动力学指标,降低炎症反应,安全性较好.%Objective To study the effect of triple therapy on GCS score ,hemoglobin level and adverse reactions in patients with acute massive cerebral infarction .Methods 110 patients with acute massive cerebral infarction who treated in our hospital were selected from January 2015 to December 2016 .They were divided into control group and experimental group randomly ,each group had 55 cases,the control group was treated with conventional therapy , the experimental group was treated with edaravone plus ganglioside plus butylphthalide .Compared the efficacy ,GCS score ,hemoglobin level and hemodynamic parameters between the two groups .Results The total effective rate of the experimental group was 94.55%, which was higher than that of the control group(P<0.05).The total effective rate of the experimental group was higher than that of the control group(P<0.05).After treatment,the NHISS score,ADL score and GCS score of the two groups were improved ,and the NHISS score of the experimental group was lower ,the ADL score and GCS score were higher than those of the control group ( P <0.05 ) .After treatment, hemodynamic indexes of two groups of patients were improved , patients in the experimental group the whole blood viscosity , plasma viscosity , fibrinogen and hematocrit levels lower than the control group ( P<0.05 ) .After treatment , the hemoglobin , CRP and IL-8 of the patients in the two groups were improved ,and the levels of hemoglobin ,CRP and IL-8 in the experimental group were lower ( P <0.05 ) .Conclusion Edaravone and ganglioside +dl-3-n-butylphthalide triple drug scheme can improve the curative effect of acute large area cerebral infarction , improve the neurological function and hemodynamics ,reduce inflammation ,good safety .