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[椎基底动脉系统缺血性卒中急性期患者的治疗:使用神经保护药物美西多宁的经验]

[Treatment of patients with ishemic stroke in the vertebral-basilar system in acute period: experience of using the neuroprotective drug Mexidol].

作者信息

Goncharova Z A, Chernikova I V, Nazarova V A, Tolmacheva V V, Ovsepian K G

机构信息

Rostov State Medical University, Rostov-on-Don, Russia.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2024;124(2):78-84. doi: 10.17116/jnevro202412402178.

Abstract

OBJECTIVE

To assess the clinical efficacy and safety of Mexidol in patients in acute period of ishemic stroke in the vertebral-basilar system (iiVBS).

MATERIAL AND METHODS

An open randomized comparative study involved 52 patients. 32 of them received Mexidol (mail group, MG) and 20 received therapy without neuroprotective drugs. Assessment of the severity of clinical manifestations of iiVBS was performed using the Hoffenberth scale, stroke severity was assessed using the NIHSS, the modified Rankin Scale was used to assess the degree of disability in patients after stroke, neuropsychological examination of patients was performed using the Montreal Cognitive Assessment (MoCA), dynamics were compared on the Hospital Anxiety and Depression Scale (HADS), Subjective assessment scale for asthenia (MFI-20), the patients' quality of life was assessed using the EQ-5D.

RESULTS

The use of Mexidol in the form of long-term sequential therapy in the patients of the MG led to a 53.3% decrease in the severity of clinical manifestations of iiVBS and a 59.5% decrease in neurological deficit according to the NIHSS scale. By the end of Mexidol therapy, 96.9% of patients MG were able to manage their own affairs without assistance (modified Rankin Scale), which was accompanied by regression of emotional disturbances and improved quality of life of patients.

CONCLUSION

Administration of Mexidol in therapy of patients with acute iiVBS can be considered the most justified, since it contributes to an earlier and more significant reduction of neurological deficit and improvement of patients' quality of life.

摘要

目的

评估美西多福对椎基底动脉系统缺血性卒中急性期(iiVBS)患者的临床疗效和安全性。

材料与方法

一项开放性随机对照研究纳入了52例患者。其中32例接受美西多福治疗(治疗组,MG),20例接受不使用神经保护药物的治疗。使用霍芬伯斯量表评估iiVBS临床表现的严重程度,使用美国国立卫生研究院卒中量表(NIHSS)评估卒中严重程度,使用改良Rankin量表评估卒中后患者的残疾程度,使用蒙特利尔认知评估量表(MoCA)对患者进行神经心理学检查,在医院焦虑抑郁量表(HADS)、虚弱主观评估量表(MFI-20)上比较动态变化,使用EQ-5D评估患者的生活质量。

结果

在MG组患者中采用长期序贯治疗形式使用美西多福,导致iiVBS临床表现严重程度降低53.3%,根据NIHSS量表神经功能缺损降低59.5%。到美西多福治疗结束时,MG组96.9%的患者能够在无协助的情况下料理自己的事务(改良Rankin量表),这伴随着情绪障碍的消退和患者生活质量的改善。

结论

在急性iiVBS患者的治疗中使用美西多福可被认为是最合理的,因为它有助于更早、更显著地减轻神经功能缺损并改善患者的生活质量。

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