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[吡拉西坦与40kDa右旋糖酐对老年脑低灌注性卒中患者疗效的比较]

[Porównanie skuteczności piracetamu i dekstranu 40 tys. u chorych w podeszlym wieku z niedokrwiennym udarem mózgu].

作者信息

Kozubski W

机构信息

Katedry i Kliniki Neurologii Akademii Medycznej im. K. Marcinkowskiego w Poznaniu.

出版信息

Wiad Lek. 1998;51(7-8):321-5.

PMID:9748886
Abstract

Piracetam is believed to restore the metabolism of glucose and 02, and also to prevent the vasospasm of small arteries in the penumbra of ischaemic focus. Taking the above into account we tried to estimate its effect in elderly patients with stroke. The studied group consisted of 47 patients, aged 60-78 years (mean 67,4 yrs), with the first ischaemic episode. 23 patients were treated with 500 ml of Dextran 40 daily and 60 ml of placebo given separately. The rest of the patients was treated with the same dose of Dextran 40 and 12 g of Piracetam as 60 ml i.v. bolus. The neurological status of the patients was estimated using Scandinavian Neurological Stroke Scale (SNSS). In the patients treated with Dextran and placebo there were no changes in the total score of SNSS, both after 10 and 28 days, comparing with the initial status. In the patients treated with Dextran and Piracetam total SNSS score improved significantly after 10 days (p < 0.05) and the effect was increased after 28 days (p < 0.02). The effect of the treatment with Piracetam was especially accentuated in the patients with aphasia (n = 13), whose status showed the most powerful improvement both after 10 (p < 0.03) and 28 days (p < 0.02). The author believes that Piracetam instituted within the first hours after stroke might improve the neurological status of the patients, especially those with aphasia.

摘要

人们认为,吡拉西坦可恢复葡萄糖和氧气的代谢,还能预防缺血灶半暗带小动脉的血管痉挛。考虑到上述因素,我们试图评估其对老年中风患者的疗效。研究组由47例首次发生缺血性发作的患者组成,年龄在60 - 78岁之间(平均67.4岁)。23例患者每天接受500毫升低分子右旋糖酐40治疗,并单独给予60毫升安慰剂。其余患者接受相同剂量的低分子右旋糖酐40和12克吡拉西坦,以60毫升静脉推注的方式给药。使用斯堪的纳维亚神经卒中量表(SNSS)评估患者的神经状态。在接受低分子右旋糖酐和安慰剂治疗的患者中,与初始状态相比,10天和28天后SNSS总分均无变化。在接受低分子右旋糖酐和吡拉西坦治疗的患者中,10天后SNSS总分显著改善(p < 0.05),28天后效果增强(p < 0.02)。吡拉西坦治疗的效果在失语症患者(n = 13)中尤为明显,他们的状态在10天(p < 0.03)和28天后(p < 0.02)均有最显著的改善。作者认为,在中风后的最初几小时内使用吡拉西坦可能会改善患者的神经状态,尤其是失语症患者。

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