摘要
目的观察联用尤瑞克林与丁苯酞注射液治疗中重度急性分水岭脑梗死的临床疗效,及其对血浆内皮素-1(ET-1)、一氧化氮(NO)和血液流变学指标水平的影响。方法选取2015年2月至2016年11月收治的急性中重度分水岭脑梗死患者108例[神经功能评分(NIHSS)>4分],随机分为对照组和治疗组,各54例。在常规抗血小板聚集、抗动脉硬化的基础上,对照组予以丁苯酞注射液治疗,治疗组予以丁苯酞注射液联合尤瑞克林治疗,两组均治疗2周。观察两组患者治疗前后血管内皮功能指标(ET-1、NO)、血液流变学指标(血浆黏度、红细胞压积、纤维蛋白原),及NIHSS和日常生活能力(ADL)评分情况,同时比较两组患者的临床疗效和不良反应发生率。结果治疗后2周,观察组和对照组的总有效率分别为92.59%、72.22%,两组比较差异有统计学意义(P<0.01);治疗后2周两组患者的血浆ET-1、血浆黏度、红细胞压积、纤维蛋白原水平及NIHSS评分均较治疗前明显降低(P均<0.01),且观察组低于对照组(P均<0.01);血浆NO水平、ADL评分均较治疗前显著升高(P均<0.01),且观察组高于对照组(P均<0.01),差异均有统计学意义。两组治疗期间的不良反应率均为3.70%。结论联用尤瑞克林与丁苯酞注射液可能更有效地纠正血清中ET-1、NO、血浆黏度、红细胞压积及纤维蛋白原水平,改善血管内皮功能及血液流变学状态,促进患者神经功能恢复,安全性高。
Objective To observe the clinical efficacy of urinary kallidinogenase combined with Butylphthalide in the treatment of moderate and severe acute cerebral watershed infarction（ACWI） and its influence on plasma endothelin-1（ET-1）,nitric oxide（NO） and hemorheology indicators. Methods A total of 108 patients with moderate and severe ACWI [National Institutes of Health Stroke Scale（NIHSS） more than 4] treated from February 2015 to November 2016 were selected and randomly divided into control group and treatment group（n = 54,each）. On the basis of conventional antiplatelet aggregation and atherosclerosis,Butylphthalide injection was given in control group,and it combined with Urinary kallidinogenase was given in treatment group. The therapy was continued for 2 weeks in both groups. ET-1 and NO,hemorheology indexes（plasma viscosity,erythrocyte deposited,fibrinogen）,and scores of NIHSS and ability of daily life（ADL） were observed before and after the treatment. Clinical efficacy and incidence of adverse reactions were compared between two groups. Results At 2 weeks after treatment,the total effective rate in treatment group was significantly higher than that in control group（92. 59% vs 72. 22%,P〈0. 01）. The levels of plasma ET-1,plasma viscosity,erythrocyte deposited,fibrinogen and NIHSS scores were significantly lower at 2 weeks after treatmet than those before treatment in both two groups（all P〈0. 01）,and were significantly lower in treatment group than those in control group（all P〈0. 01）. The level of plasma NO and ADL scores obviously increased in both two groups compared with pre-treatment and were statistically higher in treatment group than those in control group（all P〈0. 01）. The adverse reaction rate was 3. 70% during treatment in both two groups. Conclusion Urinary kallidinogenase combined with Butylphthalide may be more effective in correcting plasma ET-1,NO,plasma viscosity,erythrocyte deposited and fibrinogen,improving vascular endothelial function and hemorheology,as well as promoting neurological function recovery in the treatment of ACWI.
作者
邓伟
孙艳丽
南光贤
DENG Wei;SUN Yan-li;NAN Guang-xian(The Second Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin 130000, China)
出处
《中国临床研究》
CAS
2018年第4期467-471,共5页
Chinese Journal of Clinical Research
关键词
尤瑞克林
丁苯酞注射液
分水岭脑梗死
血管内皮功能
血液流变学
神经功能缺损
Urinary Kallidinogenase
Butylphthalide injection
Cerebral watershed infarction
Endothelial function
Hemorheology
Nerve function impairment
