辅加更昔洛韦治疗进展性卒中的临床分析(1)
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[摘要] 目的：探讨辅加更昔洛韦治疗进展性卒中的临床疗效。方法：将发病在72 h内的急性进展性脑梗死患者64例分为治疗组和对照组，各32例。治疗组在对照组常规治疗的基础上加用更昔洛韦治疗。观察两组用药后临床症状与体征停止进展的天数，并于治疗前及治疗后3、7、14、21 d分别进行神经功能缺损程度评分。结果：治疗组较对照组进展期明显缩短，神经功能缺损程度明显改善，治愈率和总有效率明显增加(P<0.01)。结论：辅加更昔洛韦抗病毒药治疗进展性卒中疗效显著，早期加用效果较好，疗程以2～3周为宜。
[关键词] 抗病毒药；更昔洛韦；进展性卒中；疗效
[中图分类号] R743.3 [文献标识码] B [文章编号] 1674-4721(2011)11(c)-053-02
The clinical curative effect of the ganciclovir in treatment evolutional apoplexy
FU Qingxian1, RONG Genman2
1.Nerve Internal Medicine Department of Zhongmeng Hospital of Kazuo County, Chaoyang City, Liaoning Province, Kazuo 122000, China; 2.The Central Hospital of Zhong Tie 19 Office, Liaoning Province, Liaoyang 111000, China
[Abstract] Objective: To investigate the clinical efficacy of stroke in progression in the treatment of ganciclovir. Methods: 64 cases of acute progressive cerebral infarction happened in seventy-two hours were divided into treatment group (32 cases) and control group (32 cases). Control group were given conventional therapy, but treatment group were given ganciclovir in addition to conventional therapy. Control of disease condition and NIHSS of two group were observed. Results: Control of disease condition, NIHSS, cure rate and total effective rate of treatment group were better than control group (P<0.01). Conclusion: Ganciclovir is particularly effective against stroke in progression. If ganciclovir is used early, its clinical efficacy is better. Two to three weeks is optimal period of treatment.
[Key words] Antivirotic; Ganciclovir; Stroke in progression; Clinical efficacy
进展性卒中(stroke in progression，SIP)是临床上常见的脑缺血性疾病，是指在发病72 h脑缺血进展或脑组织坏死加重以致神经功能恶化，经治疗后病情没有好转，仍进行性加重的脑缺血性疾病，其在全部脑梗死中占据33%～51%[1]。既往对其治疗的报道甚多，但疗效均不甚理想。现将本科在2006年1月～2008年12月收集的64例SIP患者随机分为对照组32例，治疗组32例，对照组采用抗凝、降纤、降低血小板聚集和改善微循环等治疗；治疗组采用在与对照组完全相同基础上辅加抗病毒药更昔洛韦治疗，发现疗效显著，现报道如下：
1 资料与方法
1.1 一般资料
所有脑梗死患者发病至治疗时间在1～10 d，且发病72 h局灶神经功能缺损症状仍进行性加重，其诊断均符合1995年全国第四届脑血管学术会议所制定的脑梗死诊断标准，并均经影像学资料确认，以除外脑出血。治疗组32例，其中，男22例，女10例；平均年龄(62.9±6.6)岁；按神经功能缺损程度分型：重型(31～45分)9例，中型(15～30分)15例，轻型8例；颈内动脉系29例，其中根据CT结果又分为大灶(5.1～8.0 cm)6例、中灶(3.1～5.0 cm)15例、小灶(1.5～3.0 cm)8例；椎-基动脉系3例；合并症：高血压21例 ......
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