目的评价依达拉奉联合神经节苷脂治疗老年急性脑梗死的临床疗效、对炎症因子的影响及安全性。方法将74例老年急性脑梗死患者随机分为试验组36例和对照组38例。2组患者入组后均予以抗凝、降压及改善微循环等基础治疗。试验组给予依达拉奉...目的评价依达拉奉联合神经节苷脂治疗老年急性脑梗死的临床疗效、对炎症因子的影响及安全性。方法将74例老年急性脑梗死患者随机分为试验组36例和对照组38例。2组患者入组后均予以抗凝、降压及改善微循环等基础治疗。试验组给予依达拉奉30 mg+0.9%氯化钠250 m L静脉点滴,每日2次,同时给予神经节苷脂60 mg+0.9%氯化钠250 m L静脉点滴,每日1次。对照组给予血栓通200 mg+0.9%氯化钠250 m L静脉点滴,每日1次。2组患者疗程均为4周。疗程结束后1周,评价2组的临床疗效及肿瘤坏死因子α、C反应蛋白和白细胞介素-6的变化。结果试验组总有效率91.67%显著高于对照组71.05%(P<0.05)。治疗后,2组的肿瘤坏死因子α、C反应蛋白及白细胞介素-6水平均较治疗前显著降低(P<0.05),且试验组治疗后降低更为显著(P<0.05)。2组患者不良反应发生率差异无统计学意义(P>0.05)。结论依达拉奉联合神经节苷脂治疗老年急性脑梗死的临床疗效确切,可显著降低患者体内炎症因子水平。展开更多
BACKGROUND:Portal vein thrombosis(PVT) is a potential lethal complication and may have negative influence on the prognosis after splenectomy in patients with liver cirrhosis.Prevention and timely detection of PVT are ...BACKGROUND:Portal vein thrombosis(PVT) is a potential lethal complication and may have negative influence on the prognosis after splenectomy in patients with liver cirrhosis.Prevention and timely detection of PVT are quite significant.There is a lack of knowledge about the clinical features and risk factors of PVT.Our study aimed to investigate the risk factors and clinical characteristics of PVT in order to figure out the high-risk individuals.METHODS:We collected the clinical data of 472 consecutive patients with non-neoplastic liver cirrhosis who had undergone splenectomy from January 2008 to December 2010 in our institution.Clinical and surgical characteristics of patients who developed PVT postoperatively and those who did not develop PVT were compared.Univariate and multivariate analyses of risk factors of PVT were performed.The mortality and rebleeding rate of the patients were also evaluated.RESULTS:Of the 472 patients,52 were excluded from the study.PVT developed in 71(71/420,16.9%) patients.Multivariate analysis revealed that wider preoperative portal vein diameter,postoperative thrombocytosis,prolonged prothrombin time and periesophagogastric devascularization were significantly correlated with PVT development [odds ratio(OR):5.701,2.807,1.850 and 2.090,respectively].The incidence of PVT in patients who took antiplatelet drugs was not lower than that in those who did not.Follow-up showed that patients in the PVT group had a tendency towards reduced overall survival but it was not statistically significant.Gastrointestinal bleeding occurred more often in the PVT group than that in the non-PVT group(P=0.044).CONCLUSIONS:Wider preoperative portal vein diameter,postoperative thrombocytosis,prolonged prothrombin time and periesophagogastric devascularization are independent risk factors of PVT.PVT is related with higher risk of postoperative gastrointestinal hemorrhage but has no significant impact on the overall survival.展开更多
文摘目的评价依达拉奉联合神经节苷脂治疗老年急性脑梗死的临床疗效、对炎症因子的影响及安全性。方法将74例老年急性脑梗死患者随机分为试验组36例和对照组38例。2组患者入组后均予以抗凝、降压及改善微循环等基础治疗。试验组给予依达拉奉30 mg+0.9%氯化钠250 m L静脉点滴,每日2次,同时给予神经节苷脂60 mg+0.9%氯化钠250 m L静脉点滴,每日1次。对照组给予血栓通200 mg+0.9%氯化钠250 m L静脉点滴,每日1次。2组患者疗程均为4周。疗程结束后1周,评价2组的临床疗效及肿瘤坏死因子α、C反应蛋白和白细胞介素-6的变化。结果试验组总有效率91.67%显著高于对照组71.05%(P<0.05)。治疗后,2组的肿瘤坏死因子α、C反应蛋白及白细胞介素-6水平均较治疗前显著降低(P<0.05),且试验组治疗后降低更为显著(P<0.05)。2组患者不良反应发生率差异无统计学意义(P>0.05)。结论依达拉奉联合神经节苷脂治疗老年急性脑梗死的临床疗效确切,可显著降低患者体内炎症因子水平。
基金supported by a grant from the National Natural Science Foundation of China(81127005)
文摘BACKGROUND:Portal vein thrombosis(PVT) is a potential lethal complication and may have negative influence on the prognosis after splenectomy in patients with liver cirrhosis.Prevention and timely detection of PVT are quite significant.There is a lack of knowledge about the clinical features and risk factors of PVT.Our study aimed to investigate the risk factors and clinical characteristics of PVT in order to figure out the high-risk individuals.METHODS:We collected the clinical data of 472 consecutive patients with non-neoplastic liver cirrhosis who had undergone splenectomy from January 2008 to December 2010 in our institution.Clinical and surgical characteristics of patients who developed PVT postoperatively and those who did not develop PVT were compared.Univariate and multivariate analyses of risk factors of PVT were performed.The mortality and rebleeding rate of the patients were also evaluated.RESULTS:Of the 472 patients,52 were excluded from the study.PVT developed in 71(71/420,16.9%) patients.Multivariate analysis revealed that wider preoperative portal vein diameter,postoperative thrombocytosis,prolonged prothrombin time and periesophagogastric devascularization were significantly correlated with PVT development [odds ratio(OR):5.701,2.807,1.850 and 2.090,respectively].The incidence of PVT in patients who took antiplatelet drugs was not lower than that in those who did not.Follow-up showed that patients in the PVT group had a tendency towards reduced overall survival but it was not statistically significant.Gastrointestinal bleeding occurred more often in the PVT group than that in the non-PVT group(P=0.044).CONCLUSIONS:Wider preoperative portal vein diameter,postoperative thrombocytosis,prolonged prothrombin time and periesophagogastric devascularization are independent risk factors of PVT.PVT is related with higher risk of postoperative gastrointestinal hemorrhage but has no significant impact on the overall survival.
