盐酸法舒地尔对急性脑梗死的疗效及其对血清hsCRP含量的影响

目的探讨盐酸法舒地尔对急性脑梗死的疗效及作用机制。方法选取确诊为急性脑梗死并在72h内接受治疗的住院患者，根据入院时斯堪的纳维亚卒中量表（SSS）评分及一般情况进行配对，共选择有效病例43对，分别应用法舒地尔60mg，2次／d或银杏叶提取物20mL，1次／d静脉滴注治疗，疗程均为14d。所有患者于确诊后进行SSS评分和改良Rankin量表（mRS）评分，测定血清高敏C-反应蛋白（hsCRP）含量，在治疗结束时复查SSS评分和血清hsCRP含量，1月后评估患者mRS评分。结果法舒地尔及银杏叶提取物治疗2周后SSS评分均有显著增高（P均小于0．01），法舒地尔组比银杏叶提取物组更显著（P〈0．01）；法舒地尔组神经功能及临床结局改善显著高于银杏叶提取物组（P均小于0．01）；两组患者治疗后血清hsCRP含量均明显下降（P〈0．05或P〈0．01），法舒地尔组比银杏叶提取物组更显著（P〈0．01）。两组均未观察到严重不良反应。结论法舒地尔治疗急性脑梗死安全、有效，其机制可能部分与抑制缺血脑组织炎性反应有关。

Clinical Efficacy of Fasudil in Treatment of Acute Cerebral Infarction and Its Effect on Serum High Sensitive C-Reactive Protein Content

Objective To investigate the clinical efficacy of fasudil in treatment of acute cerebral, infarction and to explore its mechanism. Methods A total of 86 patients, who were able to receive drug treatment within 72 h of acute cerebral infarction onset, were enrolled and pair-matched according to their SSS score and baseline characteristics. The patients received either 60 mg fasudil by intravenous injection over 1 mg/min, twice daily or 20 mL ginkgo biloba extract, once daily for 14 d. The primary end points were neurological status at 2 weeks after the start of treatment, and clinical outcome in 1 month after the onset of symptoms. Scandinavian stroke scale（SSS） and modified Rankin scale （mRS） were used to evaluate the neurological status and clinical outcome respectively. The high sensitive C-reactive protein （hsCRP） content was measured with the hsCRP kit in next morning after making a definite diagnosis and remeasured after the course of treatment. Results Both fasudil and ginkgo biloba extract treatment resulted in significantly improvements in neurological function （both P 〈 0.01）. The improvement of neurological functions and clinical outcome with fasudil treatment were greater than those with ginkgo biloba extract treatment （both P 〈 0. 01 ）. Both fasudil and ginkgo biloba extract decreased significantly serum hsCRP level（ P 〈 0. 05, P 〈 0. 001 respectively）, the decrease of hsCRP in fasudil treatment group was more obvious than that in ginkgo biloba extract treatment group（P 〈0.01）. Conclusion It is suggested that the treatment with fasudil within 72 h of acute infarction onset could improve the patient＇s neurological status and clinical outcome, which may partly due to its inhibiting inflammatory reaction of ischemic area.