小剂量白蛋白治疗进展型脑梗死临床研究

　　【摘要】 目的 观察小剂量白蛋白治疗进展型脑梗死疗效及治疗前后血液流变学变化。方法 70例病人随机分为两组：治疗组(35例)和对照组(35例)，均应用脱水剂，脑细胞保护剂、保持水电酸碱平衡等常规治疗。治疗组35例脑梗死患者应用白蛋白5g静脉滴注，每天2次，连续10天为1个疗程。治疗后15天复查血流变。结果 治疗组控制脑梗死进展的疗效明显高于对照组(P<0.01)。治疗组30天后疗效明显高于对照组(P<0.01)。白蛋白能降低全血高切粘度、低切粘度、血浆粘度、红细胞压积等。结论 小剂量白蛋白治疗进展型脑梗死有效。

　　【关键词】 白蛋白;进展型脑梗死;血液流变学

　　Clinic study on progressive ischemic stroke with low-dose albumin

　　BIANBA Cangjue.

　　Department of Cadre Health Care, Lhasa People’s Hospital, Lhasa 850000,China

　　【Abstract】 Objective To evaluate the efficacy of low-dose albumin to treat progressive ischemic stroke and the change of hemorrheology before and after treatment.Methods 70 progressive ischemic stroke patients were randomly divided into tow groups：treatment group(35 cases)and control group(35 cases)。All patients were treated by normal methds(treating brain edema,protective neuron,keeping fluid and electrolyte balance).The treatment group patients were treated by intravenous injection with 5g albumin two time everyday for 10 d;the hemorrheology of all patients of the treatment group and the control group were examined after 15 d.Results The clinical effect of progressive ischemic stroke in the treatment group was significantly better than the control group(P<0.01).The clinical curative effect of the treatment group showed better outcome than that of the control group after one 30d(P<0.01).The results of hemorrheology after 15 d showed the low-dose albumin can declined blood viscosity,blood plasma viscosity and hemotocrit.Conclusion The treatment of progressive ischemic stroke with low-dose albumin is effective.

　　【Key words】 albumin;progressive ischemic stroke;hemorrheology

　　进展型脑梗死是脑梗死中病情最严重的一种类型，治疗是否及时正确对预后影响很大。我院自1999年4月—2004年4月应用小剂量白蛋白治疗进展型脑梗死35例。现报告如下。

　　1 资料与方法

　　1.1 一般资料 70例均选自我院急诊观察和住院病人。入选条件符合1986年中华医学会第二次全国脑血管学术会议制定的诊断标准。经头颅CT或MRl确诊。发病后病情进展符合进展型脑梗死的诊断标准[1]。发病后60h内未应用其他抗凝药和溶栓药。随机分为两组：(1)白蛋白组(下称治疗组)35例，男20例，女15例;年龄45～74岁

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