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目的:评价高压氧联合依达拉奉、奥扎格雷钠治疗急性脑梗死(ACI)的临床疗效,观察其对患者血液流变学指标与血浆血栓素A_2(TXA_2)、前列腺素I_2(PGI_2)水平的影响。方法:86例急性脑梗死患者随机分为治疗组与对照组:其中治疗组45例,应用高压氧联合依达拉奉、奥扎格雷钠进行治疗;对照组41例单用奥扎格雷钠,对比分析等两组治疗前后神经功能缺损评分(NHSS)、Barthel指数(BI)和血液流变学指标变化,同时采用放射免疫法检测患者治疗前后血浆TXA_2和PGI_2含量,最后比较两组患者的临床疗效。结果:①治疗组基本治愈率和总有效率分别为28.89%、91.11%,优于对照组17.07%的基本治疗愈率和80.49%的总有效率(P<0.01),两组均无明显不良反应。②经过治疗,患者NHSS评分明显下降,而BI评分明显升高(P<0.01或0.05),且治疗组改善程度高于对照组(P<0.01或0.05)。③治疗后,患者各血液流变学指标均明显下降(P<0.01或0.05),其中治疗组血小板凝集率、纤维蛋白原水平和血液粘稠度降低幅度大于对照组(P<0.05)。④经过治疗,两组血浆TXA_2水平下降,PGI_2水平上升,TXA_2/PGI_2比值减少(P<0.01),其中治疗组变化明显好于对照组(P<0.01或0.05)。结论:高压氧联合依达拉奉、奥扎格雷钠治疗急性脑梗死能减轻脑细胞损伤,改善神经功能障碍,疗效显著,值得临床推广。
OBJECTIVE: To evaluate the clinical efficacy of hyperbaric oxygen combined with edaravone and ozagrel sodium in the treatment of acute cerebral infarction (ACI), and to observe the relationship between hemorheological parameters and plasma TXA 2, PGI 2, Horizontal impact. Methods: Eighty-six patients with acute cerebral infarction were randomly divided into treatment group and control group. The treatment group (45 cases) was treated with hyperbaric oxygen combined with edaravone and ozagrel sodium. In the control group, 41 cases were given ozagrel sodium alone, The changes of neurological deficit score (NHSS), Barthel index (BI) and hemorheology indexes before and after treatment were compared between the two groups. The contents of TXA_2 and PGI_2 in plasma before and after treatment were measured by radioimmunoassay. The clinical data of two groups were compared Efficacy. Results: ① The basic cure rate and total effective rate of the treatment group were 28.89% and 91.11%, respectively, which was better than the control group of 17.07% and the total effective rate of 80.49% (P <0.01) reaction. ② After treatment, the NHSS score decreased significantly, while the BI score was significantly increased (P <0.01 or 0.05), and the treatment group improved more than the control group (P <0.01 or 0.05). ③ After treatment, all the indexes of hemorrheology were significantly decreased (P <0.01 or 0.05). The reduction rate of platelet aggregation rate, fibrinogen level and blood viscosity in the treatment group was greater than that in the control group (P <0.05). ④ After treatment, plasma TXA 2 level decreased, PGI 2 level increased, TXA 2 / PGI 2 ratio decreased (P <0.01), and the treatment group changed significantly better than the control group (P <0.01 or 0.05). Conclusion: Hyperbaric oxygen combined with edaravone and ozagrel sodium in the treatment of acute cerebral infarction can reduce brain cell injury and improve neurological dysfunction, with significant curative effect and worthy of clinical promotion.