刘静静

[摘要]目的 探讨依达拉奉对短暂性脑缺血（TIA）进展患者神经缺损功能的改善效果及其机制。方法 选取2015年4月～2016年4月在我院神经内科住院且符合入选标准的120例TIA患者作为研究对象，根据ABCD2危险分层分为高、中、低危组，各40例。将各亚组分为A组（依达拉奉治疗高危）、B组（依达拉奉治疗中危）、C组（依达拉奉治疗低危）、D组（基础治疗高危）、E组（基础治疗中危）、F组（基础治疗低危），各20例。比较各组发作时、治疗后第3、14、28天的NIHSS评分及日常生活活动能力评分，并记录不良反应发生情况。结果 C组和F组治疗后第3、14、28天的NIHSS评分显著低于A、B、D、E组，A组的NIHSS评分低于D组，B组的NIHSS评分低于E组，差异有统计学意义（P<0.05）。各组治疗后第3、14、28天的NIHSS评分均降低，差异有统计学意义（P<0.05）。C组和F组治疗后第3、14、28天的Barthel指数评分显著高于A、B、D、E组，A组的Barthel指数评分高于D组，E组的Barthel指数评分高于B组，差异有统计学意义（P<0.05）。各组治疗后第3、14、28天的日常生活活动能力评分均升高，差异有统计学意义（P<0.05）。各组均无明显不良反应。结论 依达拉奉可改善TIA高危、中危组的神经功能缺损，且安全性较高。

[关键词]依达拉奉；短暂性脑缺血发作；神经功能缺损；缺血/再灌注

[中图分类号] R743.31 [文献标识码] A [文章编号] 1674-4721（2016）10（b）-0107-04

[Abstract]Objective To explore the improvement of neurologic function impairment and the mechanism for Edaravone in patients with transient ischemic attack （TIA）.Methods 120 patients with TIA admitted to the department of neurology in our hospital and met the inclusion criteria from April 2015 to April 2016 were selected and divided into the highrisk group，the medium risk group and the low risk group according to risk stratification of ABCD2，40 cases in each group.Each subgroup was divided into group A （high risk group treated with Edaravone），group B （medium risk group treated with Edaravone），group C （low risk group treated with Edaravone），group D （high risk group treated with the basis for treatment），group E （medium risk group treated with the basis for treatment），group F （low risk group treated with the basis for treatment），20 cases in each group.The score of NIHSS and the score of daily life activities ability among each group was compared in attack，after treatment at the 3rd days，14th days，28th days and the incidence rate of adverse reaction was recorded.Results The score of NIHSS after treatment at the 3rd days，14th days，28th days in group C and group F was lower than that in group A，group B，group D，group E，the score of NIHSS after treatment at the 3rd days，14th days，28th days in group A was lower than that in group D，the score of NIHSS after treatment at the 3rd days，14th days，28th days in group B was lower than that in group E，with significant difference （P<0.05）.The score of NIHSS after treatment at the 3rd days，14th days，28th days in each group were all decreased，and the difference was statistically significant （P<0.05）.The score of daily life activities ability after treatment at the 3rd days，14th days，28th days in group C and group F was higher than that in group A，group B，group D，group E，the score of daily life activities ability after treatment at the 3rd days，14th days，28th days in group A was higher than that in group D，the score of daily life activities ability after treatment at the 3rd days，14th days，28th days in group B was higher than that in group E，with significant difference （P<0.05）.The score of daily life activities ability after treatment at the 3rd days，14th days，28th days in each group were all increased，and the difference was statistically significant （P<0.05）.There was no obvious adverse reaction in each group.Conclusion Edaravone can improve the neurologic function impairment of high，moderate risk groups with TIA，and the security is higher.

[Key words]Edaravone；Transient ischemic attack；Neurologic function impairment；Ischemia/reperfusion

随着我国人口老龄化的日趋加剧，脑卒中的发病率呈逐年上升趋势[1-3]，其中短暂性脑缺血发作（transient ischemic attack，TIA）因其可干预性较强，越来越受到人们重视。TIA发生缺血/再灌注损伤几乎不可避免。依达拉奉（Edaravone，MCI-186）作为神经细胞保护剂，具有清除自由基、抑制脑细胞的过氧化作用，可减轻脑缺血及继发脑水肿及组织损伤。本研究给予TIA患者依达拉奉干预治疗，旨在探讨依达拉奉对TIA缺血/再灌注的疗效及机制。

1资料与方法

1.1一般资料

选取2015年4月～2016年4月在我院神经内科住院且符合入选标准的120例TIA患者作为研究对象，年龄50～78岁，平均（65±4.2）岁。根据ABCD2评分分为高危组（6～7分）、中危组（4～5分）和低危组（0～3分），各40例。将各亚组分为A组（依达拉奉治疗高危）、B组（依达拉奉治疗中危）、C组（依达拉奉治疗低危）、D组（基础治疗高危）、E组（基础治疗中危）、F组（基础治疗低危），各20例。……