目的 探讨银杏提取物联合氟西汀治疗急性脑梗塞后抑郁的临床疗效.方法 130例急性脑梗塞后抑郁的患者被随机分为观察组和对照组,每组65例;对照组患者仅服用氟西汀;观察组在对照组治疗的基础上,采用银杏提取物对患者进行治疗.使用汉密尔顿抑郁量表(HAMD)评价疗效.结果 治疗前两组患者的HAMD评分无显著性差异(P＞0.05);治疗后4周、治疗后6周和治疗后8周,观察组患者的HAMD评分明显低于对照组,两组间评分比较显著性差异(P＜0.05);对两组患者的临床疗效进行统计分析,发现观察组和对照组的总有效率分别为81.54％和66.15％,观察组的总有效率明显高于对照组,两组间总有效率差异显著(P＜0.05).结论 银杏提取物联合氟西汀治疗急性脑梗塞后抑郁的作用显著,效果明显优于单一使用氟西汀的治疗疗效.

Objective To evaluate the safety and efficacy of multi-mode CT guided arterial thrombolysis and intravenous thrombolysis with rt-PA in treatment of acute cerebral infarction.Methods The carotid artery system in patients with acute cerebral infarction 65 cases were randomly divided into arterial thrombolysis group of 35 patients and intravenous thrombolytic group of 30 patients,record the NIHSS score and living ability status before thrombolysis and after thrombolysis 2h,24h,7d and 30d.Determine the efficacy of thrombolysis after 30 days.Results Arterial thrombolysis group average NIHSS score results were significantly lower than the intravenous thrombolysis group.Two groups total effective rate were 74.29% and 46.67% respectively.Conclusion Intra-arterial thrombolysis and venous thrombolysis guided by multi-mode CT are safe,effective in treatment of acute cerebral infarction,clinical efficacy of the former is superior to the latter.

Objective To explore clinical efficacy of early treatment for post cerebral concussion syndrome.Methods To- tally 187cases of the patients with mild,moderate cerebral concussion in our hospital were selected and were divided into three groups randomly,treated with energy mixture,nimodipine and intravenous injection of erigeron breviscapus.Treatment effects of the three groups at 7d,21dafter the treatment were compared.After three months of follow-up,the recurrence of the three groups was analyzed.Results At 7d,21dafter the start of treatment,the treatment efficacy of erigeron breviscapus group(87.50%,96.88%),was significantly higher than them of nimodipine(72.13%,80.33%)and energy mixture group(58.06%,61.29%,P<0.05).At the following 3months after injury,the ocurrence rate of post-concussion syndrome in the erigeron breviscapus group(4.69%)was significantly lower than that of nimodipine group(22.95%)and energy mixture group(38.71%,P<0.05).Conclusion It is important for improving initial symptoms and inhibitions of post-traumatic syn- drome to early select effective medicine on cerebral concussion symptoms

目的:探讨奥扎格雷钠针联合阿托伐他汀钙治疗急性脑梗死的临床疗效。方法:回顾性分析我科收治的162例急性脑梗死患者,分为治疗组和对照组,两组均应用拜阿司匹林、苦碟子和吡拉西坦治疗,治疗组加用阿托伐他汀钙和奥扎格雷钠。结果:治疗组的总有效率明显高于对照组的76.25%,治疗组神经功能的缺损程度轻于对照组,且在治疗过程中未发生不良反应。结论:奥扎格雷钠针联合阿托伐他汀钙治疗急性脑梗死,有助于神经功能恢复。

Objective To Nimodipine(trade names:Nimotop) in patients with poststroke depression on cognitive function improvement.Methods 267 cases of patients with poststroke depression were randomly divided into two groups,conventional treatment of the primary disease,rehabilitation training and Seroxat Tablets 20 mg/d,the treatment group at the same time on the basis of a combination of nimodipine tablets with 30 mg,3 times/d,each group of patients with treatment and follow-up to 12 over the weekend.Pre-treatment and treatment in the first 4 weeks,8 weeks and 12 weekends in Montreal Cognitive Assessment Scale(Montreal Cognitive Assessment,MoCA) and HAMILTON Depression Scale score.Results Two groups of patients before treatment using MOCA Depression Scale score and HAMILTON score by t test P0.05,no significant difference;4 weeks after treatment,8 weeks,12 weeks of treatment group and above the control group by t test score comparison P0.05,significant difference.Conclusion Nimotop can be effective in improving mild to moderate post-stroke depression in patients with cognitive function.

Objective To observe the curative effects of treatment with Edaravone for acute massive cerebral infarction.Methods 48 patients with acute massive cerebral infarction were randomized into the treatment with Edaravone group(Edaravone group,24 patients) and the conventional treatment control group(control group,24 patients).Two groups patients were admitted conventional treatment for cerebral infarction.Edaravone group patients were admitted with Edaravone 30 mg into 100 ml saline infusion introvenously,twice a day,linked 20 ～ 25 d.Respectively before and after the treatment,neurologic function dificit score(NDS),plasma fibrinogen(Fib) content,coagulation blood function,activity of superoxide dismutase(SOD) were examined.The clinical efficacy was compared between the two groups.Results NDS of tow groups after treatment were significantly lower than those of before treatment,activity of SOD were significantly increased than those before treatment(all P0.05).Edaravone group improvement were obviously better than those in the control group(all P0.05).Plasma Fib contents and coagulation blood function in the two groups before and after treatment were no statistically significant difference(all P0.05).Significant efficiency ratio of the Edaravone group(87.5%) was significantly higher than that of the control group(45.8%)(P0.05).In the Edaravone group,there were 2 cases in liver transaminases mildly elevated,4 cases in blood urea nitrogen elevated.After corresponding treatment,these cases were back to normal in the short term.Conclusion Treatment with Edaravone for acute massive cerebral infarction is effectual,no obvious adverse reactions.

Objective To observe the efficacy of ginkgo biloba extract combining hydrolyzate of cerebral protein in the treatment of cerebral infarction,and its effect on hemorheology index.Methods 132 cases of patients with cerebral infarction were randomly divided into therapeutic group and control group.The therapeutic group were given Shu Xue Ning 20ml,cerebral protein injection 60mg,intravenous dripx 1 time per day.The changes of efficacy and hemorheology index were observed after 14 days continuous treatment.Results Compared with the control group,the efficacy and hemorheology index of the therapeutic group were improved greatly.Conclusion Ginkgo biloba extract(Shu Xue Ning) combining hydrolyzate of cerebral protein can reduce the viscosity of blood,and improve the function of nerves.

With the development of modern medical science,people have made great progress in understanding the transient ischemic attack.This article reviews some contemporary recognition about transient ischemic attack in its conception,etiology,pathogenesis,clinical classification,imaging,effect on neuroprotection,influence on cognitive function,diagnosis,treatment,progosis and so on.

<正>目前血管性认知障碍(VCI)的治疗尚无特效药物,除胆碱酯酶抑制剂外,脑血管扩张剂、钙离子通道拮抗剂、脑代谢赋活剂、抗氧化剂等都在临床上广泛应用。作者用具有神经细胞和脑血管双靶位作用的药物普洛迪治疗血管性认知障碍58例,以观察其临床效果,现总结报告如下。