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目的 评价环磷酰胺、秋水仙碱联合应用治疗急性脑梗死的有效性、安全性。方法 多中心、随机对照临床试验将 32 5例发病 72h内入院的脑梗死患者分为两组 ,对照组 16 2例 ,接受急性脑梗死的基本治疗 ;处理组 16 3例 ,接受环磷酰胺 0 .1～ 0 .2g/d、秋水仙碱 1mg/d和基本治疗 ,共 10d。两组患者分别于入院时、发病后 2周及 1、2、3个月进行改良爱丁堡 斯堪的纳维亚脑卒中量表 (MESSS)评分 ,于发病后 2周及 1、2、3个月行日常生活活动能力评分 (BI)。同时测定部分患者治疗前后血清烯醇酶 (NSE)水平。采用发病后 3个月减少的MESSS百分数和 3个月末BI评分评价疗效。结果 (1)处理组神经功能缺损评分较对照组明显减低 (P <0 .0 5 ) ,而日常生活活动能力评分处理组显著高于对照组 (P <0 .0 5 ) ;(2 )处理组NSE治疗后下降较对照组有显著性差异 (P<0 .0 5 ) ;(3)处理组有2 2例发生副作用 (占 13.8% ) ,其中白细胞减少 7例 ,恶心 11例 ,呕吐 3例 ,腹泻 8例。对照组 5例发生副作用 ,腹泻2例 ,恶心不适 3例。结论 环磷酰胺、秋水仙碱联合应用治疗急性脑梗死患者 ,能显著减轻患者神经功能缺损 ,改善预后 ;但此疗法有一定的副作用 ,临床使用时应严密观察
Objective To evaluate the efficacy and safety of cyclophosphamide and colchicine in the treatment of acute cerebral infarction. Methods A multicenter, randomized clinical trial of 32 5 cerebral infarction patients admitted within 72 hours after onset of illness was divided into two groups: control group, 162 patients received basic treatment of acute cerebral infarction; treatment group, 16 3 patients received cyclophosphamide 0 .1 ~ 0.2g / d, colchicine 1mg / d and basic treatment, a total of 10d. Two groups of patients were admitted to hospital, 2 weeks after onset and 1, 2, 3 months to improve the Scandinavian Stroke Scale score (MESSS), 2 weeks after onset and 1, 2, 3 Monthly activity rating of daily living (BI). At the same time, the level of serum enolase (NSE) in some patients before and after treatment was measured. Efficacy was assessed using the percentage reduction of MESSS at 3 months and the BI score at the end of 3 months. Results (1) The score of neurological deficit in the treatment group was significantly lower than that in the control group (P <0.05), while the activity score of daily living in the treatment group was significantly higher than that in the control group (P <0.05); (2) There was significant difference between the NSE group and the control group (P <0.05); (3) There were 22 cases of side effects (13.8%) in the treatment group, including 7 cases of leukopenia, 11 cases of nausea and 3 cases of vomiting Cases, diarrhea in 8 cases. In the control group, 5 cases had side effects, 2 cases of diarrhea, 3 cases of nausea and discomfort. Conclusions Combination of cyclophosphamide and colchicine in the treatment of patients with acute cerebral infarction can significantly reduce neurological deficits and improve prognosis in patients with acute cerebral infarction. However, this therapy has some side effects and should be closely observed in clinical use