The Effect Of Hydroxyethyl Starch On Patients With Acute Ischemic Cerebral Stroke

Background and objectiveThere were many studies found that Hydroxyethyl starch(HES)had serious adverse reaction on renal function and blood coagulation system,leading to increased mortality,therefore,the efficacy and safety of became a hot debate.Since 2010,more than 90 articles of professor Boldt had been questioned,the efficacy and safety of HES caused another concern,the United States food and drug administration(FDA)warned twice on the drug,European drug administration drug risk assessment committee had issued a statement,banned HES to be used to liquid resuscitation on severe burns,sepsis,such as the critical patients.Although there were many clinical meta-analyses found that in the process of using HES the renal and blood coagulation were dysfunctional,but most of the studies were about to critical patients,there were not many researches about safety evaluation of HES on other relatively light disease.Prior studies have found that HES for low perfusion ischemic cerebrovascular disease had exact curative effect,However,there were some researches observed it was not effective,and there were not large-scale clinical observationes about its adverse reactions in these patients.This study was to observe the curative effect and the damage of kidney and blood coagulation system on acute ischemic stroke(ACI)patients.Methods2014.10 to 2016.10 in the Fifth Affiliated Hospital of Zhengzhou University 55 hospitalized patients with acute ischemic cerebral stroke were chosen as control group,given conventional treatment such as atherosclerosis,antihypertensive,hypoglycemic;62cases as experimental group for our study,given HES130/0.4 500 ml of sodium chloride,ivgtt,qd,14 d on the basis of conventional treatment.Collected datum in different periods of on admission,7 days,14 days treatment,treatment after 1 month and 3 months after treatment,the following indexes were collected: nerve function defect degree,daily life ability index,blood coagulation function and renal function.Datum collection were completed by the unified training two doctors.The statistical analysis were used by the SPSS 17.0 software package.Measurement datum conformed to normal distribution were indicated by(sx ±),which did not conform to the normal distribution used the median(M)and the upper and lower quartiles(Q),bivariate normal distribution data used single factor analysis of variance(ANOVA),repetitive measure analysis of variance,non-parametric rank and inspection.Significant levels of α = 0.05.ResultsThere were no significant differences in the traditional risk factors between the two groups before and after admission.The neurological deficits and daily life index of the two groups were significantly improved(P <0.05,<0.05),the NIHSS and BI were also significantly improved at the same time point(P <0.05)other than on admission;During treatment,creatinine and urea nitrogen were on the high side(P < 0.05,< 0.05),estimated glomerular filtration rate were on the low side(P < 0.05),but at the third month after treatment,the indicators were improved;The control group renal function indicators were not obvious deterioration;The experimental group and control group coagulation function in addition to the experimental group’s APTT slightly extended,the remaining indicators were no significant differences.ConclusionHES caused varying degrees injury on renal function and coagulation system in acute ischemic stroke patients,but 3 months after treatment,the renal injury and coagulation function in patients were improved;We did not find HES increased the risk of bleeding;Compared with the control group,the NIHSS and BI in experimental group were significantly improved.Therefore,when we controlled the indications strictly,the drug therapeutic value was positive.