马来酸桂哌齐特治疗急性脑梗死的疗效分析

目的 探讨马来酸桂哌齐特在辅助治疗急性脑梗死中的应用价值.方法 选择我院2011-03-2013-03收治的急性脑梗死患者80例,按不同治疗方式随机均分为对照组（常规治疗辅以血栓通）和实验组（常规治疗辅以马来酸桂哌齐特）,对2组患者的治疗效果进行比较.结果 实验组总有效率82.5%,明显高于对照组的55.0%（P＜0.05）;实验组治疗14 d后神经功能缺损评分均明显低于对照组（P＜0.05）;2组患者经治疗14 d后的血浆纤维蛋白原水平比较差异有统计学意义（P＜0.05）.结论 马来酸桂哌齐特治疗急性脑梗死效果显著,能明显改善患者神经功能,值得临床推广应用.     

马来酸桂哌齐特对急性中重型颅脑损伤患者的疗效观察

目的 探讨马来酸桂哌齐特对急性中重型颅脑损伤患者的治疗作用。方法 将40例急性颅脑损伤患者随机分为马来酸桂哌齐治疗组(治疗组)和胞二磷胆碱治疗组(对照组),每组20例。所有患者药物治疗均在颅脑损伤后12小时内,在脱水、抗炎、神经营养等常规治疗基础上,治疗组加用马来酸桂哌齐特静脉滴注320mg/d,连续14天为1个疗程。对照组则加用胞二磷胆碱静脉滴注0.75g/d。根据意识觉醒时间、GCS评分、GOS评分以及TCD等,比较两组患者病情恢复情况。结果 急性中重型颅脑损伤治疗中,治疗组在意识觉醒时间上与对照组相比具有明显统计学意义(P<0.05);在不同时期GCS评分上,治疗组与对照组相比也具有明显统计学差异(P<0.05);GOS评分治疗组预后明显优于对照组,具有非常明显的统计学意义(P<0.01);TCD结果显示治疗组缓解脑血管痉挛效果优于对照组。结论 急性颅脑损伤早期应用马来酸桂哌齐特,可降低颅脑外伤后的病残程度,提高治疗效果。     

马来酸桂哌齐特对脑出血血肿体积和周围水肿带的影响

目的探讨马来酸桂哌齐特对高血压性脑出血血肿、水肿吸收及神经功能恢复的影响。方法90例高血压性脑出血患者,随机分为2组,对照组给予常规治疗,治疗组加用马来酸桂哌齐特(160mg/d)静滴。入组前、治疗7、21d测定神经功能评分、血肿和水肿体积。结果治疗7d,治疗组血肿体积、水肿体积及CSS评分明显小于对照组(P<0.05);治疗21d,治疗组无论血肿体积、水肿体积还是CSS评分均较对照组显著减少(P<0.05)。治疗21d神经功能评分与血肿体积相关性较高(P<0.01),与水肿体积无相关性(P>0.05)。结论马来酸桂哌齐特有利于高血压性脑出血水肿和血肿的吸收,改善脑出血的预后。     

马来酸桂哌齐特注射液治疗急性脑梗死血液流变学变化及疗效观察

目的 观察马来酸桂哌齐特注射液治疗急性脑梗死的临床疗效和对血液流变学的影响.方法 选择发病72 h内的脑梗死患者152例,按随机数字表法分为观察组(n=88)和对照组(n=64).观察组给予马来酸桂哌齐特注射液320mg.对照组给予复方丹参注射液20mL,均静脉滴注,1次/d,连用14d,观察两组临床疗效和血液流变学指标变化.结果 观察组治疗14d后的中国卒中量表(CSS)评分与对照组比较差异有统计学意义(P<0.05);观察组疗效、显效率(62.5%)优于对照组(35.9%),差异有统计学意义(P<0.05);观察组治疗后的各血液流变学指标下降程度较对照组明显,差异有统计学意义(P<0.05).结论 马米酸挂哌齐特注射液治疗急性脑梗死疗效显著,并能有效降低血液黏度.     

马来酸桂哌齐特治疗急性脑梗死的疗效及对血液流变学的影响

目的：观察马来酸桂哌齐特注射液治疗急性脑梗死的临床效果及对血液流变学的影响。方法选择2009-12-2012-12我院内科收治的急性脑梗死患者133例,随机分为治疗组68例和对照组65例。2组均给予常规基础治疗,治疗组在对照组基础上应用马来酸桂哌齐特注射液320 mg加入500 mL 0.9％氯化钠注射液中静滴,1次/d ,共应用14 d ,治疗前后采用改良爱丁堡-斯堪的那维亚量表（SSS ）与日常生活能力（ADL ）量表对2组患者的疗效进行评定。对比治疗前后2组患者血液流变学指标变化。结果治疗7 d、14 d后治疗组SSS评分、ADL评分与对照组比较差异有统计学意义（ P＜0.05）。治疗组治疗前后SSS评分、ADL评分比较差异有统计学意义（ P＜0.05）。2组治疗后总有效率比较差异有统计学意义（ P＜0.05）。治疗组治疗后血液流变学指标均较治疗前有显著改善（ P＜0.05）。结论马来酸桂哌齐特注射液治疗急性脑梗死安全有效,且能显著改善患者的血液流变学指标。     

马来酸桂哌齐特对脑缺血大鼠模型胞外信号调节激酶表达的影响

目的观察马来酸桂哌齐特预处理对大鼠脑缺血半暗带区胞外信号调节激酶(ERK1/2)磷酸化表达的影响,探讨其对脑缺血的保护作用及可能的作用机制。方法采用改良线栓法建立大鼠永久性大脑中动脉阻塞(pMCAO)模型。SD大鼠随机分为1马来酸桂哌齐特组(pMCAO模型大鼠,n=57。尾静脉注射马来酸桂哌齐特3.0 mg·kg-1,×5d);2对照组(pMCAO模型大鼠,n=57。尾静脉注射生理盐水0.5 mL,×5 d);3假手术组(不插线栓,n=50。尾静脉注射生理盐水0.5 mL,×5 d);4正常组(n=3,不做任何处理)。应用TTC染色法测定梗死体积,蛋白印迹法和免疫组化法检测不同时间点(术后3、6、24、48和72 h)缺血半暗带区ERK蛋白的表达。结果马来酸桂哌齐特组与对照组比较,梗死体积减少17.91%(P=0.001)。马来酸桂哌齐特组缺血半暗带pERK1/2表达于3 h开始增加,24 h达高峰[为正常的(5.75±0.70)倍]后逐渐降低,72 h仍为正常的(2.89±0.51)倍,各时间点与正常组比较,均差异有显著统计学意义(P0.01)。6、24和48 h 3个时间点,马来酸桂哌齐特组缺血半暗带内pERK1/2表达较对照组增加(P0.05)。pERK的免疫组化检测示马来酸桂哌齐特预处理能上调缺血半暗带区内ERK磷酸化表达(P0.05)。结论马来酸桂哌齐特预处理可减少脑梗死体积,并能上调缺血半暗带区的ERK磷酸化表达;参与MAPK信号通路、上调缺血半暗带区内ERK磷酸化的表达,可能是其保护缺血性脑损伤的机制之一。     

马来酸桂哌齐特在颅脑损伤患者的治疗效果观察

目的通过随机分组对照观察探讨马来酸桂哌齐特对颅脑损伤患者的治疗效果。方法100例急性闭合性颅脑损伤患者，分为对照组和用药组，各50例病人。分析对比治疗后对照组和用药组的实验室各项检查指标：血液流变学，TCD检查结果等变化情况。并且对出院后3—6个月随访调查结果进行比较分析。结果治疗后血液流变学检查中，用药组（马来酸桂哌齐特组）各项指标均低于对照组（P〈0．05）。经颅多普勒检测结果显示：用药组的脑血流速度与对照组相比明显减慢（P〈0．05），血管痉挛得到缓解。对比两组出院后随访结果可以看出，用药组的GOS评分、KPS评分及Barthel指数预后明显好于对照组（P〈0.05）。结论初步证明急性颅脑损伤早期应用马来酸桂哌齐特可增加病变区的脑血流，改善微循环，改善颅脑损伤患者的预后。值得推广和进一步研究。     

马来酸桂哌齐特联合长春西汀治疗急性脑梗死疗效观察

目的观察马来酸桂哌齐特联合长春西汀治疗急性脑梗死的临床疗效及安全性。方法选择临床确诊的急性脑梗死患者76例,随机分成治疗组和观察组各38例。治疗组给予马来酸桂哌齐特注射液320mg,长春西汀30mg,阿司匹林0.1g口服,每晚1次;对照组给予长春西汀30mg,阿司匹林0.1g口服,每晚1次,连用14d。治疗期间采用中国卒中量表（CSS）对神经功能缺损进行评定。结果 治疗组临床总有效率89.5%,对照组为65.8%,治疗组疗效明显优于对照组,2组总有效率比较差异有统计学意义（P〈0.01）。结论 马来酸桂哌齐特联合长春西汀治疗脑梗死疗效显著,能有效改善脑梗死患者神经功能,值得临床进一步推广。     

马来酸桂哌齐特注射液联合阿司匹林肠溶片治疗急性脑梗死的临床观察

急性脑梗死是神经内科的常见病和多发病,目前对脑梗死的治疗多采用改善脑缺血、防止血栓形成、保护神经细胞等综合治疗方法[1].马来酸桂哌齐特注射液(商品名克林澳,每支80 mg/2 mL,由北京四环制药有限公司生产)是一种新型心脑血管治疗药物,具有腺苷增效及弱钙通道阻滞的双重作用,同时还有扩张血管、增加红细胞柔韧性、降低血液黏度、改善血循环及营养脑细胞的多重作用,对血压及脉搏影响不大.     

马来酸桂哌齐特联合舒血宁治疗急性脑梗死的疗效观察

目的观察马来酸桂哌齐特联合舒血宁治疗急性脑梗死的疗效及安全性。方法选取我院2009-02—2012-10收治的急性脑梗死患者200例,随机分成对照组和联合治疗组各100例。对照组在常规治疗的基础上加用舒血宁;联合治疗组在对照组的基础上加用马来酸桂哌齐特。治疗前后检查血、尿常规、血脂、血糖、肝肾功能、凝血功能、心电图等。结果经数理统计学分析,联合治疗组明显优于对照组(P<0.05);2组安全性方面比较差异无统计学意义(P>0.05)。结论马来酸桂哌齐特联合舒血宁在治疗急性脑梗死方面疗效确切、安全。     

马来酸桂哌齐特联合奥扎格雷钠治疗急性脑梗死的疗效观察

目的 观察马来酸桂哌齐特联合奥扎格雷纳注射液治疗急性脑梗死（ACI）的疗效.方法 将116例ACI患者随机分为治疗组（马来酸桂哌齐特联合奥扎格雷钠）60例和对照组（单用奥扎格雷钠）56例,分别于入院时、治疗后7,14,28 d进行临床神经功能缺损程度（NDS）评分和治疗后28 d疗效评定,治疗90 d时的Barthel指数;分别在治疗前后测血液流变学、经颅多普勒（TCD）检查;两组进行比较.结果 2组治疗后14 d及21 d神经功能缺损评分均有明显改善,但治疗组与对照组的NDS、Barthel指数、血液流变学、TCD变化等比较差异均有统计学意义（P＜0.05）.结论 马来酸桂哌齐特联合奥扎格雷钠可增加急性脑梗死的脑血流,改善微循环,并有助于ACI患者的神经功能恢复.     

马来酸桂哌齐特联合甲钴胺治疗糖尿病周围神经病变的临床观察

目的观察马来酸桂哌齐特联合甲钴胺治疗糖尿痛周围神经病变（DPN）的临床疗效。方法将120例DPN患者随机分为两组,联合治疗组60例,对照组60例。两组在积极控制血糖的基础上,联合治疗组予马来酸桂哌齐特注射液（克林澳,北京四环制药有限公司）160mg加入生理盐水250ml静脉滴注,1次／d,连用2周;同时予治疗组用甲钴胺粉针剂1mg加入生理盐水100ml中静脉滴注,1次／d,连用2周后改口服甲钴胺片1mg,3次／d×2周;对照组予维生素B1100mg和维生素B12250μg肌内注射,1次／d,连用2周后改口服维生素B1片20mg,3次／d＋维生素B12片50μg,3次／d×2周。比较两组治疗前后症状、体征、神经传导速度变化及不良反应。结果治疗组患者症状体征明显改善、感觉及运动神经传导速度有显著提高,与对照组比较差异具有统计学意义（P均〈0．01）。结论马来酸桂哌齐特与甲钴胺联合应用可明显提高对糖尿病周围神经病变（DPN）的治疗疗效。     

马来酸桂哌齐特治疗高血压性脑出血临床疗效及安全性观察

目的 探讨马来酸桂哌齐特对高血压性脑出血的出血、水肿吸收以及神经功能损伤恢复方面的临床疗效,同时观察其不良反应.方法 98例高血压性脑出血患者,随机分为对照组和治疗组,对照组给予高血压性脑出血常规治疗,治疗组加用马来酸桂哌齐特320mg静滴,每日1次,共用14d.分别于治疗前、治疗14d后测定血肿和水肿体积、NIHSS评分、Barthel指数及血压、心率水平、血白细胞计数(WBC)、肝肾功能、血糖及凝血功能,并观察不良反应发生情况.结果 治疗14d后治疗组血肿、水肿体积均较对照组明显缩小,差异具有统计学意义(P<0.05);两组病例NIHSS评分及BI评分治疗前后差异均有统计学意义(P<0.05),治疗14d后治疗组NIHSS评分及BI评分差异具有统计学意义(P<0.05);两组显效率及总有效率差异均具有统计学意义(P<0.05);治疗组治疗前后患者心率、血白细胞计数(WBC)、肝肾功能及凝血功能等各项指标差异均无统计学意义.结论 马来酸桂哌齐特可促进高血压性脑出血水肿和血肿吸收,改善神经功能缺损及病残程度,不良反应出现少,安全性较好.

Abstract：

Objective To evaluate the clinical efficacy and safety profile of cinepazide maleate for the treatment of hypertensive hemorrhage by observing the absorption of blood blots and brain edema, recovery of nervous system functions,and adverse reaction of this drug. Methods 98 patients with hypertensive hemorrhage were divided into two groups randomly:the control group and the therapy group. Patients in the control group were given routine treatment, while patients in therapy group were administrated with cinepazide maleate 320mg ivgtt. Qd, and the course of treatment was 14 days for both groups. Volume of blood blot and edema, NIHSS score, Barthel index (BI), blood pressure, heart rate, WBC, ALT, AST, Cr,BUN, blood glucose and blood clotting function of each patient were all evaluated before and after treatment course;meanwhile, adverse reactions were under tight observations. Results After treatments for 14 days,a significant decrease in volumes of blood blot and edema was noticed in all patients of therapy group compared to those of control group ( P < 0.05 ).Statistical differences of NIHSS score and BI were observed in two groups before and after treatments ( P < 0.05 ), this trend also existed in the comparison between therapy group and control group ( P < 0. 05 ). There were significant differences of effect efficiency in two groups ( P < 0. 05 ), with the same as the total effect efficiency ( P < 0.05 ). No statistical differences of heart rate,WBC,ALT, AST, Cr, BUN, blood glucose and blood clotting function were detected in therapy group before and after treatments. Conclusions Cinepazide maleate may facilitate the absorption of blood blot and edema for patients with hypertensive hemorrhage, improve the impaired function of nervous system, and decrease the disability extent.Moreover,cinepazide maleate is a safe drug with few adverse reactions.     

Effects of tanshinone Ⅱ sodium sulfonate plus cinepazide maleate on the hemorrheologic indexes and blood lipids in patients with acute cerebral infarction

BACKGROUND: The severity of cerebral infarction is associated with the increase of blood viscosity caused by hyperfibrinogenemia and hyperlipidemia, etc. Thus it has become one of the target for treating cerebral infarction to decrease blood viscosity by integrated Chinese and western medicine. OBJECTIVE: To investigate the influence and clinical therapeutic effects of cinepazide maleate combined with tanshinone Ⅱ A sodium sulfonate on the hemorrheologic indexes and blood lipids of patients with acute cerebral infarction, and compare the results with those of simple cinepazide maleate treatment. DESIGN: A non-randomized case-controlled observation. SETTINGS: Hebei North University; the Second Affiliated Hospitals of Hebei North University; the Third Affiliated Hospitals of Hebei North University. PARTICIPANTS: Eighty-six inpatients with cerebral infarction were selected from the infirmary, the Second and Third Affiliated Hospitals of Hebei North University from September 2004 to October 2006. They were all diagnosed to have acute cerebral infarction by CT or MRI, and accorded with the diagnostic standards for acute cerebral infarction set by the Fourth National Academic Meeting for Cerebrovascular Disease in 1995. Meanwhile, 40 teachers and medical staff of voluntary physical examinees were selected as the control group. Informed contents were obtained from all the patients and their relatives. METHODS: The patients were divided into combined treatment group (n=43) and simple treatment group (n=43). In the combined treatment group, the patients were administrated with 160 mg cinepazide maleate injection (Beijing Four-ring Pharmaceutical, Co.,Ltd, No. H200220125; 80 mg/2 mL) added in 5% glucose, and 40 mg tanshinone Ⅱ sodium sulfonate (Shanghai No.1 Biochemical & Pharmaceutical Co.,Ltd., No. H31022558, 10 mg/2 mL) added in 250 mL normal saline. In the simple treatment group, the patients were only administrated with cinepazide maleate 320 mg added in 5% glucose or 250 mL normal saline. They were treated for 1 or 2 courses, once a day, and 14 days as a course. The patients were detected before treatment and at 14 and 28 days after treatment respectively. ① Determination of hemorrheologic indexes: Whole blood viscosity was determined with LBY-N6B automatic hemorrheologic meter; Plasma viscosity with LBY-F200B automatic plasma viscosity meter; Volume of fibrinogen was determined by the method of 12.5% sodium nitrate depositing biuret reaction. ② Determination of blood lipids: The serum levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were determined. ③ Severity of neurological deficit: The total score of neurological deficit score (NDS) ranged from 0 to 45 points, 0–15 points was taken as mild, 16–30 points as moderate and 31–45 points as severe. ④ Evaluation of curative effects: Generally cured: NDS decreased by 91%–100%, and disabled severity of grade 0; Significantly improved: NDS decreased by 46%–90%, and disabled severity of grades 1–3; Improved: NDS decreased by 18%–45%; No change: NDS decreased by less than 18%; Aggravated: NDS increased by more than 18%. Generally cured and significant improved were taken as significant effect. ⑤ The adverse events and side effects after medication were observed. MAIN OUTCOME MEASURES: ① Results of hemorrheologic indexes and blood lipids; ② NDS results in the combined treatment group and simple treatment group; ③ Therapeutic effects and adverse events. RESULTS: All the 86 patients with cerebral infarction and 40 healthy controls were involved in the analysis of results. ① Results of hemorrheologic indexes and blood lipids: The hemorrheologic indexes and blood lipids before treatment were manifested as abnormalities to different extents in both the combined treatment group and simple treatment group; The hemorrheologic indexes after treatment were obviously improved in both groups. But the hemorrheologic indexes were improved more obviously in the combined treatment group as compared with those in the simple treatment group (P < 0.05); The levels of TC, TG and LDL-C after treatment in the combined treatment group were obviously lowered (P < 0.05), whereas those in the simple treatment group were not significantly changed (P > 0.05). ② NDS results: The NDS scores at 14 and 28 days after treatment in the combined treatment group [(6.23±2.34), (4.27±1.83) points] were obviously lower than those in the simple treatment group [(8.76±3.41), (6.65±2.49) points, P < 0.05]. ③ Therapeutic effects and side effects: The total significant effective rates in the combined treatment group and simple treatment group were 93% and 81% respectively. In the combined treatment group, 1 case suffered from palpitation, dizziness and agrypnia. In the simple treatment group, 1 case suffered from palpitation, dizziness and agrypnia, 1 case had itch of skin. All the above symptoms disappeared gradually after the transfusing speed was adjusted to be slower. No drug withdrawal occurred in the patients due to the adverse events. CONCLUSION: Cinepazide maleate combined with tanshinon can obviously improve the abnormalities of hemorrheologic indexes and blood lipids and nerve function in patients with acute cerebral infarction, and its curative effect is faster than that of simple cinepazide maleate treatment.