Takabatake Yasushi, Uno Eiichi, Wakamatsu Kouichi, Yamazaki Noriaki, Hashimoto Norichika, Tsuchiya Yoshitake
Department of Neurosurgery, Fukuiken Saiseikai Hospital, 7-1 Funabashi, Wadanaka-cho, Fukui 918-8503, Japan.
No To Shinkei. 2003 Jul;55(7):589-93.
Sodium ozagrel (ozagrel), a selective thromboxane A2 synthetase inhibitor, has been used for the treatment of various types of acute ischemic stroke, except cardioembolic stroke. Recently, edaravone, a novel free radical scavenger, has been approved for the treatment of acute ischemic stroke within 24 hours after onset. Since these two drugs differ in mode of action, we hypothesized that combination of both drugs would yield further improvement of the outcome of patients with acute ischemic stroke. The clinical efficacy of combination therapy with edaravone and ozagrel for acute ischemic stroke was studied retrospectively, and compared with that of ozagrel alone. A total of 62 patients who suffered acute ischemic stroke within 24 hours after onset during the 10-month period from June 2001 to March 2002, were treated with both edaravone and ozagrel (E-O group), while 76 patients during August 2000 to May 2001, were treated with ozagrel alone (O group). The rate of modified Rankin Scale (MRS) 0 and 1 at discharge in the total ischemic stroke and atherothrombotic stroke, was significantly higher in the E-O group than in the O group. The improvement in MRS also differed between E-O group and O group in total. The difference was significant in patients with atherothrombotic stroke but not in those with lacunar stroke. These results indicate that combination therapy with edaravone and ozagrel is more effective than mono-therapy with ozagrel for the treatment of acute ischemic, especially of atherothrombotic stroke.
奥扎格雷钠（奥扎格雷）是一种选择性血栓素A2合成酶抑制剂，已被用于治疗除心源性栓塞性卒中之外的各种类型的急性缺血性卒中。最近，一种新型自由基清除剂依达拉奉已被批准用于治疗发病24小时内的急性缺血性卒中。由于这两种药物的作用方式不同，我们推测这两种药物联合使用会使急性缺血性卒中患者的预后得到进一步改善。我们回顾性研究了依达拉奉与奥扎格雷联合治疗急性缺血性卒中的临床疗效，并与单独使用奥扎格雷的疗效进行了比较。2001年6月至2002年3月这10个月期间，共有62例在发病后24小时内发生急性缺血性卒中的患者接受了依达拉奉和奥扎格雷联合治疗（依达拉奉-奥扎格雷组），而在2000年8月至2001年5月期间，有76例患者仅接受了奥扎格雷治疗（奥扎格雷组）。在总缺血性卒中和动脉粥样硬化血栓形成性卒中患者中，依达拉奉-奥扎格雷组出院时改良Rankin量表（MRS）评分为0和1的比例显著高于奥扎格雷组。依达拉奉-奥扎格雷组和奥扎格雷组在MRS改善方面总体也存在差异。在动脉粥样硬化血栓形成性卒中患者中差异显著，但在腔隙性卒中患者中差异不显著。这些结果表明，依达拉奉与奥扎格雷联合治疗急性缺血性卒中，尤其是动脉粥样硬化血栓形成性卒中，比单独使用奥扎格雷治疗更有效。
