中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2013, Vol. 8 ›› Issue (9): 792-801.doi: 10.3969/j.issn.1673-5374.2013.09.003

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

血栓通提高老年腔隙性脑梗死患者脑血流灌注水平

  

  • 收稿日期:2012-12-13 修回日期:2013-02-25 出版日期:2013-03-25 发布日期:2013-03-25
  • 基金资助:

    浙江省中医药科技基金项目（No. 2012ZA077）

Xueshuantong improves cerebral blood perfusion in elderly patients with lacunar infarction

Qifeng Gui1, Yunmei Yang1, Shihong Ying2, Minming Zhang3   

  1. 1 Department of Geriatrics, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
    2 Department of Radiology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
    3 Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
  • Received:2012-12-13 Revised:2013-02-25 Online:2013-03-25 Published:2013-03-25
  • Contact: Yunmei Yang, Doctoral supervisor, Department of Geriatrics, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China, yangyunmei2008@sina.com.
  • About author:Qifeng Gui★, Master, Attending physician.
  • Supported by:

    This study was supported by the Technological Foundation Project of Traditional Chinese Medicine Science of Zhejiang Province, No. 2012ZA077.

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摘要：

研究纳入64例24 h内首次起病的老年急性腔隙性脑梗死患者，分别给予抗血小板、降血脂等常规治疗，或在常规治疗基础上静脉滴注450 mg主要成分为三七皂苷的血栓通，1次/d。治疗4周后，所有患者的美国国立卫生研究院卒中量表评分均有所降低，日常生活活动评分明显增高，但简易精神状态量表评分变化不明显。与常规治疗者比较，应用血栓通治疗的患者以上指标改善更明显。动态磁敏感对比磁共振灌注成像结果显示，经4周治疗后，所有患者感兴趣区病灶的相对脑血流量增多，而相对平均通过时间减少，其中应用血栓通治疗的患者以上指标改善更明显。可见血栓通能改善老年腔隙性脑梗患者的临床症状，提高患者梗死灶的血流灌注水平。

关键词: 神经再生, 中医药, 脑血管疾病, 血栓通, 脑灌注, 腔隙性脑梗死, 老年人, 动态磁敏感对比磁共振灌注成像, 三七总皂苷, 神经保护, 基金资助文章, 图片文章

Abstract:

A total of 64 patients with acute lacunar infarction were enrolled within 24 hours of onset. The patients received conventional therapy (antiplatelet drugs and hypolipidemic drugs) alone or conventional therapy plus 450 mg Xueshuantong once a day. The main ingredient of the Xueshuantong lyophilized powder used for injection was Panax notoginseng saponins. Assessments were made at admission and at discharge using the National Institutes of Health Stroke Scale, the Activity of Daily Living and the Mini-Mental State Examination. Additionally, the relative cerebral blood flow, relative cerebral blood volume and relative mean transit time in the region of interest were calculated within 24 hours after the onset of lacunar infarction, using dynamic susceptibility contrast magnetic resonance perfusion imaging technology. Patients underwent a follow-up MRI scan after 4 weeks of treatment. There was an improvement in the Activity of Daily Living scores and a greater reduction in the scores on the National Institutes of Health Stroke Scale in the treatment group than in the control group. However, the Mini-Mental State Examination scores showed no significant differences after 4 weeks of treatment. Compared with the control group, the relative cerebral blood flow at discharge had increased and showed a greater improvement in the treatment group. Furthermore, there was a reduction in the relative mean transit time at discharge and the value was lower in the treatment group than in the control group. The experimental findings indicate that Xueshuantong treatment improves neurological deficits in elderly patients with lacunar infarction, and the mechanism may be related to increased cerebral perfusion.

Key words: neural regeneration, traditional Chinese medicine, Xueshuantong, cerebral perfusion, lacunar infarction, Panax notoginseng saponins, cerebrovascular disease, neuroprotection, grants-supported paper, photographs-containing paper, neuroregeneration