Objective To observe the short-term effect and safety of hyperbaric oxygen combined with edaravone and ozagrel sodium in treating progressive cerebral infarction. Methods A total of 65 in-patients with acute progressive cerebral infarction were randomly divided into two groups: 33 in-patients in the trial group were treated by hyperbaric oxygen combined with edaravone and ozagrel sodium, while the other 32 in-patients in the control group were treated by edaravone and ozagrel sodium. The course of treatment was 14 days. The following indications were assessed before and after the treatment respectively: the national institutes of health stroke scale (NIHSS), activities of daily living (ADL), and clinical effects. Results This study showed that the scores of both ADL and NIHSS in the trial group were higher than those in the control group, with significant differences (Plt;0.05). The clinical effective rate of the trial group was 90.91% which was obviously higher than the control group with a significant difference (P=0.028). There were no obvious adverse reactions in both groups. Conclusion Hyperbaric oxygen combined with both edaravone and ozagrel sodium is notable in short-term effect and safe, thus it is worth being popularized in clinical treatment.
Objective To assess the effectiveness and safety of edaravone for acute cerebral infarction. Methods We searched The Cochrane Central Register of Controlled Trials （ Issue 2, 2005 ）, MEDLINE （ 1966 to Aug. 2005）, EMBASE （ till Aug. 2005 ）, the China Biological Medcine Database （ till Aug. 2005 ）, the Chinese Stroke Clinical Trials Database （ till August 2005 ） and the reference lists of related articles. Two reviewers independently selected studies, assessed quahty of studies and extracted data. The RevMan 4.2 software was used for statistical analysis. Results We identified 12 randomized controlled trials, of which 9 （ n = 948 ） were included. The level of methodology quality was B. Since the conventional therapy was different among some studies, the improvement of disability and long-term death rate and incidence of adverse reactions were not included by meta-analysis. Meta-analysis on the improvement of neurological deficit showed a better effectiveness of edaravone than control with statistical significance [ OR2.98, 95% CI （ 1.39,6.39 ） ]. Possible adverse reactions to edaravone included abnormal liver function and skin rash. Conclusions With relatively poor quality of most included trials and small sample size, insufficient evidence is obtained to support the conclusion that edaravone is safe or effective in the treatment of acute cerebral infarction. Further high quality and large sample randomized controlled trials should be carried out.
目的:研究银杏达莫联合血塞通注射液对急性脑梗死的治疗效果。方法:分成3组,分别为银杏达莫组、血塞通组、银杏达莫联合血塞通治疗组,每组40例。3组给予不同治疗后分别对治疗前及治疗后14、21 d对神经功能缺损及疗效进行评定。结果:银杏达莫组及血塞通组相比,在治疗后第14及21天,银杏达莫联合血塞通组神经功能缺损明显减轻(Plt;005),且疗效更明显(Plt;005)。结论:与银杏达莫组及血塞通组相比,银杏达莫与血塞通联合治疗可更加改善神经功能缺损(Plt;005),并能提高疗效,出血副作用无增加。
摘要:目的:观察阿托伐他丁对脑梗死大鼠脑保护的作用以及对脑源性神经营养因子(braindeprived neurotrophic factor,BDNF)的影响。方法: 线栓法制备SD大鼠大脑中动脉梗死(middle cerebral artery occlusion,MCAO)再灌注模型。将大鼠随机分为:假手术组;MCAO组的2 h、24 h、3 d、5 d组;阿托伐他丁组的2 h、24 h、3 d、5 d组。MCAO组和阿托伐他丁组的各时程组再分别分为脑梗死体积亚组、免疫组化亚组,每亚组及假手术组各6只大鼠。在不同时间点观察阿托伐他丁组和MCAO组大鼠神经行为评分、脑梗死体积,用免疫组化法检测BDNF阳性细胞数。结果: 神经行为评分和脑梗死体积在阿托伐他丁组和MCAO组的2 h组之间无显著性差异(Pgt;0.05),在阿托伐他丁24 h、3 d、5 d组均显著低于对应时程的MCAO组(Plt;0.05);各组缺血半暗带BDNF阳性细胞数均增高,但阿托伐他丁组的阳性细胞数显著高于对应时程的MCAO组(Plt;0.05)。结论:阿托伐他丁能提高大鼠局灶脑缺血半暗带BDNF的表达水平,促进神经元的修复。Abstract: Objective: To observe the effect of atorvastatin in cerebral protection and braindeprived neurotrophic factor(BDNF) in rats. Methods: Ischemic reperfusion model of rats as established by an intraluminal filament and recirculation at different time point respectively. One hundred and two healthy SD rats were randomly assigned into three groups for different preconditioning, including the sham surgery group (SS, n=6), the sham and middle cerebralartery occlusion (MCAO) group (MCAO, n=48), and the atorvastatin and MCAO group (atorvastatin +MCAO, n=48). The latter two groups were further divided into two subgroups on different time points of tests. Each subgroup hase six rats. In the atorvastatin +MCAO group, intragastric administration of atorvastatin was given for five days, then the MCAO followed. In the MCAO group, the MCAO was given directly. The neurophysical marks and the volume of the cerebral infarction in atorvastatin group and MCAO group were determined at different time point. The expression of BDNF was valued by immunohistochemitry respectively. Results: At 2 h, there were no differences in the neurophysical marks and volume of the cerebral infarction between atorvastatin group and MCAO group (Pgt;0.05). At 24 h,3 d,5 d, the neurophysical marks and volume of the cerebral infarction of atorvastatin group were lower than that of MCAO group in the corresponding time (Plt;0.05). Around the necrotic areas,BDNF positive neurons were increased in both groups, but they were higher in atorvastatin group than in MCAO group in the corresponding time (Plt;0.05). Conclusion: Atorvastatin could increase the expression level of BDNF and promote the ischemic neuron to revive.
目的:初步探讨体外血浆脂蛋白过滤器（DELP）对急性脑梗死患者的临床疗效及安全性。方法:采用随机、基础治疗平行对照试验设计，将符合入选标准的患者随机分为两组:试验组3例，发病48 h内和间隔一天上午接受DELP治疗，对照组2例，仅给予基础治疗。用NIHSS量表，Barthel指数和改良Rankin评分评价神经功能恢复状况。结果:治疗后14 d治疗组NIHSS降低趋势明显优于对照组，治疗后90 d治疗组mRS良好预后的患者比例显著高于对照组。两组均未发现明显不良反应，治疗前后两组的实验室指标无显著变化。结论:DELP治疗急性脑梗死所致的神经功能缺损效果及安全性良好，为临床急性脑梗死的治疗提供了一条新的途径。
目的:观察依达拉奉联合高压氧治疗脑梗死的疗效。方法:50例脑梗死随机分成2组，对照组25例采用依达拉奉治疗30 mg，静脉滴注2次/d，疗程14 d，观察组采用依达拉奉治疗的同时给予高压氧治疗，14 d后评定疗效。结果:观察组和对照组的有效率分别是96%和88%，对照组与观察组比较Plt;0.05，差异有统计学意义。结论:依达拉奉联合高压氧治疗脑梗死是一种更有效的治疗方法，值得推广。
Objective To summarize cl inical experience of carotid endarterectomy (CEA) in treating severe carotid stenosis. Methods Between October 1998 and January 2010, 215 patients with carotid stenosis were treated with CEA. There were 140 males and 75 females with an average age of 66 years (range, 51-88 years). Transient ischemic attack (TIA) occurred in127 cases, and 31 cases had history of cerebral infarction. All cases were diagnosed definitely by selective angiography and/or CT angiography, and stenosis degree was more than 80%; contralateral carotid artery was also involved in 45 cases. Ninty-six cases were found to have coronary artery stenosis by coronary angiography. CEA and coronary artery bypass grafting were performed simultaneously in 25 cases. Peripheral arterial disease was found in 43 cases and treated at the same time. Results A total of 155 patients were followed up 6-72 months. The cl inical symptom significantly alleviated in 148 cases postoperatively. Two cases had compl ication of cerebral hemorrhage within 1 week postoperatively; one died and the other was resumed after the conservative treatment. One case had hypoglossal nerve injury. Four cases had injuring marginal mandibular branch of the facial nerve, and no special treatment was given. Restenosis was found in 25 patients, and the stenosis degree was less than 25%; moreover, the patients had no TIA. One case died of heart attack at 3 years of follow-up period. Conclusion CEA is an effective and safe method for treating severe carotid stenosis.
Objective To evaluate the effectiveness and safety of edaravone combined with Xingnaojing injection in the treatment of adult acute cerebral infarction. Methods Databases including PubMed, EMbase, The Cochrane Library, CBM, CNKI, VIP and WanFang Data were searched from inception to March 2012 to identify the randomized controlled trials (RCTs) on edaravone combined with Xingnaojing injection for adult acute cerebral infarction. Two reviewers independently selected the literature, extracted the data and assessed the methodological quality of the included RCTs, and then meta-analysis was performed using RevMan 5.0 software. Results A total of 9 RCTs involving 1 098 patients were included. The results of meta-analyses showed: a) The edaravone combined with Xingnaojing injection group was superior to the Xingnaojing injection group with significant differences in the effective rate (OR=3.43, 95%CI 2.44 to 4.82, Plt;0.000 01), significantly-effective rate (OR=2.33, 95%CI 1.78 to 3.05, Plt;0.000 01), mortality (OR=0.38, 95%CI 0.15 to 0.95, P=0.04), ESS score after treatment (7 days after treatment: SMD=–0.48, 95%CI –0.80 to –0.17, P=0.003; 14 days after treatment: SMD=–0.89, 95%CI –1.17 to –0.62, Plt;0.000 01; 1 month after treatment: SMD=–0.89, 95%CI –1.20 to –0.59, Plt;0.000 01) and NDS score after treatment (7 days after treatment: MD=10.42, 95%CI 4.78 to 16.05, P=0.000 3; 14 days after treatment: MD=13.82, 95%CI 12.86 to 14.79, Plt;0.000 01; 21 days after treatment: MD=10.33, 95%CI 4.43 to 16.23, P=0.000 6); and b) The edaravone + Xingnaojing injection + conventional therapy group was superior to the conventional therapy group with significant differences in the effective rate (OR=3.03, 95%CI 1.36 to 6.73, P=0.006), significantly-effective rate (OR=2.86, 95%CI 1.50 to 5.44, P=0.001) and ESS score after treatment (7 days after treatment: MD=–6.26, 95%CI –8.49 to –4.03, Plt;0.000 01; 14 days after treatment: MD=–6.43, 95%CI –8.73 to –4.13, Plt;0.000 01). Conclusion Current evidence shows edaravone combined with Xingnaojing injection is obviously superior to either Xingnaojing injection or conventional therapy for adult acute cerebral infarction. But this conclusion still needs to be further proved by more high-quality and large-scale RCTs because of the low quality of the included studies.
Objective To research on the effect of protoparaxaxotrid saporlirs (PTS), active component in Sanqi Tongshu Capsule, on the expressions of the serum level of IL-6 and VEGF of patients with the acute cerebral infarction at different time points. Method 86 patients were randomly divided into two groups: PTS group and Nimodipine group, healthy person as control group. ELISA was applied to measure the serum level of IL-6 and VEGF in during different phases (3 d, 7 d, 14 d and 28 d after the onset of cerebral infarction). Results The expressions of VEGF rose significantly in the all of ACI patients. The expressions of IL-6 rose significantly on third day, then began to decrease. The serum level of IL-6 declined significantly (Plt;0.05) and the serum level of VEGF rose in both of PTS group and Nimodipine group in contrast with control group (Plt;0.01). Conclusion PTS can promote the expressions of VEGF after the cerebral infarction at different time points, and decrease the expressions of IL-6 in the early period of ACI, decreased，which may be one of the molecular mechanisms of this PTS in treating acute cerebral infarction.