Newsletter No. 288

Information in this section can only  be accessed with CWEM password .   若要瀏覽本部分的資料， 請須輸 入 中大校園電子郵件密碼 。 中大通訊 CUHK Newsletter 4 新概念治療中風 New Concept in Stroke Therapy 中 風是引致死亡及殘障的主因之一，每年香港有超 過兩萬人因中風須入院治療。中文大學研究顯 示，體外反搏治療能夠增加腦血流，並加快中風病人神 經功能缺損的恢復。 缺血性中風是由於腦部供血不足引起。目前的治療大部 分都集中在中風後康復的層面，但在治療方面較不足。 體外反搏是治療中風患者的臨床方法，可改善患者心、 腦和腎等內臟器官的血液供應，但至今有關的研究數據 極少。中大醫學院內科及藥物治療學系和何善衡心腦血 管病中心合作，最近針對動脈粥樣硬化所致的中風，以 體外反搏治療進行先導試驗，以評估體外反搏對缺血性 中風患者腦血流的改善情況。 研究人員自二零零四年起，在威爾斯親王醫院對五十名 中風病人進行體外反搏治療，三十二名為男性，女性十 八名。二十五名病人病發後即就接受每天一小時，共三 十五小時的體外反搏（早治療組，第一至七週），另外 二十五名病人從第八週開始接受體外反搏（晚治療組， 第八至十四週）。 結果發現，早治療組病人在七週後腦血流增加 49ml/min， 而晚治療組僅增加 28ml/min。除腦血流明顯改善，早治 療組並沒有病人出現嚴重傷殘，相反地晚治療組中就有 兩成四的病人有嚴重傷殘。另外，早治療組中有一名病 人再次中風，而晚治療組中則有四人。由此顯示，體外 反搏治療的療效令人鼓舞，醫學院將會繼續在亞洲多個 國家進行大型臨床研究。 S troke is a major cause of death and disability in Hong Kong. Every year, more than 20,000 patients are admitted to hospital for stroke treatment. Ischemic stroke is caused by a blockage of blood flow to the brain. Apart from physiotherapy and occupational therapy, no other treatment can enhance neurological recovery. External counterpulsation (ECP) can improve endothelial function and enhance blood flow to the heart, brain and kidney but there have been very few good clinical studies in this field. The Department of Medicine and Therapeutics and the S.H. Ho Cardiovascular Disease and Stroke Centre at The Chinese University has recently completed a pilot study on the use of ECP to access the effect of ECP on brain blood flow in stroke patients with relevant large artery occlusive disease. 50 stroke patients (32 men and 18 women) at the Prince of Wales Hospital have been studied since 2004. After seven weeks of ECP, patients who received immediate therapy had an increase of 49 ml/min blood flow when compared to 28 ml/min in the group receiving late therapy. The stroke deficit also improved more quickly in the early group. By 14 weeks, none of the patients in the early group had severe disability versus 24% of those in the late group. Besides, repeated strokes occurred in only one patient in the early group and four in the other. ECP appears to be safe and effective for increasing brain blood flow and enhancing neurological recovery after stroke. An international clinical trial is being planned in many countries in Asia to confirm this encouraging result. 內科及藥物治療學講座教授黃家星教授示範使用體外反搏 儀器 Prof. Lawrence K.S. Wong, professor of Medicine and Therapeutics, demonstrating the use of ECP