Analysis Of Therapeutic Effect Of Salvianolate Lyophilized Injection In Treatment Of Patients With Acute Large Artery Atherosclersis Cerebral Infarction

Objective:By observing the change of the National Institutes of Health Stroke Scale(NIHSS)score,Barthel index(BI),fibrinogen(FIB)in patients with acute large artery atherosclerosis(LAA)cerebral infarction on admission and after 14 days of treating combined with Salvianolate lyophilized injection,and the change in the above-mentioned indexes of the various pathogenesis subgroups of LAA,we evaluated the efficacy of the drug.During the course of medication,we observed whether there were any adverse reactions such as changes of liver and kidney function,myocardial enzymes,rashes,skin and mucosal gastrointestinal bleeding,hemorrhagic transformation after cerebral infarction.Methods:Cases of acute cerebral infarction with definite diagnosis were collected from September 2016 to August 2017 in our hospital.The patients were randomly divided into control group(basic treatment group)and experimental group(drug group).The control group was given conventional treatment of cerebral infarction,and the experimental group in the regular treatment combined with Salvianolate lyophilized injection.The treatment period was 14 days.After perfecting the relevant examination,patients who did not meet the diagnostic criteria of LAA in the Chinese Ischemic Stroke Subclassification(CISS)were excluded.We compared the changes of NIHSS score,BI,FIB,liver and kidney function,myocardial enzyme and other indicators in the two groups after the admission and 14 days of treatment.The patients in the experimental group were divided into four subgroups according to the pathogenesis of LAA,and the above index changes among the subgroups were compared.We observed whether the patient had skin rash,skin and mucous membrane gastrointestinal bleeding,cerebral infarction bleeding transformation and other events.Results:1.According to the standard,100 patients were included in this study.There were40 males and 10 females with an average age of(62.84±10.99)years old in the control group.Among them,the number of people with hypertension,diabetes,smoking and drinking was 27,10,28,16respectively.The experimental group included 50 cases,39males and 11 females,mean age(58.28±12.39)years old,and the number of people with hypertension,diabetes,smoking and drinking was 30,8,35,14respectively.There was no statistical difference in gender composition,age distribution and risk factor distribution between the two groups(P>0.05).2.On admission,there were no statistical differences in NIHSS scores and BI between the control group and the experimental group(Z=-0.063,0.391,P=0.950,0.696).After 14 days of treatment,NIHSS scores of both groups were lower than those at admission;BI was higher than that at admission.The differences were statistically significant(P<0.05).Compared with the control group,the NIHSS score of the experimental group was lower(Z=-2.677,P=0.007)and BI was higher(Z=-3.125,P=0.002).3.At the time of admission,the serum FIB levels in the control group and the experimental group was(3.96±0.93)g/L and(3.94±0.64)g/L,and the difference was not statistically significant(t=-0.121,P=0.904).After 14 days of treatment,two groups of FIB had different reduce.FIB in the control group was(3.79±0.89)g/L,which was no statistical difference compared with admission(t=1.452,P=0.153).FIB in the experimental group was(3.38±0.84)g/L,which was statistical difference compared with admission(t=5.408,P<0.05).4.The subgroup analysis of LAA in the experimental group showed that there were15 cases of Parent artery(plaque or thrombus)occluding penetrating artery,21 cases of Artery to artery embolism,5 cases of Hemodynamic/impaired emboli clearance and 9cases of Multiple mechanism.There was no significant difference in different subgroups in the NIHSS score,BI,FIB(?~2=7.406,4.831,1.501,P=0.060,0.185,0.682).5.There was no abnormity in the liver function,kidney function,myocardial enzyme,and there was no rash,skin mucous membrane or gastrointestinal bleeding,cerebral infarction bleeding transformation among patients during the course of medication.There was no statistical difference between the two groups(P>0.05).Conclusion:Salvianolate lyophilized injection can reduce NIHSS score,increase BI,and decrease the level of FIB in patients with acute LAA cerebral infarction.There is no significant difference in efficacy between the LAA subgroups.It has no obvious influence on liver function,renal function,myocardial enzyme,and the side effect is small.