降纤酶治疗急性脑梗塞对患者脑血流动力学和神经功能影响
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摘要
目的探讨降纤酶治疗急性脑梗塞患者的对患者脑血流动力学、神经功能的影响。方法选取我院2015年5月至2017年5月收治的150例急性脑梗死患者,采用随机数字表法分为联合组和对照组各75例,两组均给予基础疗法,联合组同时给予降纤酶治疗;对比两组患者治疗前后的大脑中动脉血流动力学收缩期峰值血流速度(Vmax)、平均血流速度(Vmean)、阻力指数(PI)、血浆纤维蛋白原(FIB)、凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血酶时间(APTT)、神经功能缺损评分(NIHSS)。结果治疗前,两组患者的大脑中动脉Vmax、Vmean、PI差异无统计学意义(P>0. 05);治疗后,联合组患者的Vmax、Vmean测定值高于对照组,PI值显著低于对照组,差异有统计学意义(P<0. 05)。治疗前,两组患者的FIB、PT、TT、APTT测定值差异无统计学意义(P>0. 05);治疗后,联合组患者的PT、TT、APTT测定值高于对照组,FIB值显著低于对照组,差异有统计学意义(P<0. 05)。治疗前,两组患者的NIHSS评分差异无统计学意义(P>0. 05);治疗后1周、治疗30天,联合组患者的NIHSS评分低于对照组,两组患者的NIHSS评分在治疗后均较治疗前显著的降低,差异有统计学意义(P<0. 05)。结论降纤酶治疗急性脑梗塞患者能显著的改善患者的凝血功能、大脑中动脉血流速度,从而改善患者的神经功能。
Objective To investigate the effect of defibrase on cerebral hemodynamics and neurological function in patients with acute cerebral infarction.Methods 150 patients with acute cerebral infarction admitted to our hospital from May 2015 to May 2017 were selected.Participants were randomly assigned to combined treatment group and control groupby random number table method,with 75 patients in each group.Basic therapy was applied to both groups while combined treatment group received additional defibrase treatment; Hemodynamics of the middle cerebral artery including peak systolic velocity( Vmax),mean blood flow velocity( Vmean) and resistance index( PI) of,plasma fibrinogen( FIB),prothrombin time( PT),thrombin time( TT),activated partial thrombin time( APTT),and nerve function defect score( NIHSS) before and after treatment were compared between two groups.Results There was no significant difference in Vmax、Vmean、PI between two groups before treatment( P>0. 05).After treatment,however,Vmax and Vmean values of patients in the combined group were higher than those in the control group while PI values were higher in the control group( P< 0. 05). Similarly,no significant difference in FIB,PT,TT and APTT values was observed at baseline( P>0. 05).After treatment,the combined treatment group had higher PT,TT,APTT and lower FIB values than the control group( P<0. 05).Before treatment,there was no difference in NIHSS scores between the two groups( P> 0. 05).Significantly lower NIHSS scores were noticed in both groups after treating for 1 week or 30 days and the combined treatment group showed a more obvious decrease( P< 0. 05). Conclusion Defibrase therapy could improve the coagulation function and blood flow velocity of the middle cerebral artery in patients with acute cerebral infarction.
Objective To investigate the effect of defibrase on cerebral hemodynamics and neurological function in patients with acute cerebral infarction.Methods 150 patients with acute cerebral infarction admitted to our hospital from May 2015 to May 2017 were selected.Participants were randomly assigned to combined treatment group and control groupby random number table method,with 75 patients in each group.Basic therapy was applied to both groups while combined treatment group received additional defibrase treatment; Hemodynamics of the middle cerebral artery including peak systolic velocity( Vmax),mean blood flow velocity( Vmean) and resistance index( PI) of,plasma fibrinogen( FIB),prothrombin time( PT),thrombin time( TT),activated partial thrombin time( APTT),and nerve function defect score( NIHSS) before and after treatment were compared between two groups.Results There was no significant difference in Vmax、Vmean、PI between two groups before treatment( P>0. 05).After treatment,however,Vmax and Vmean values of patients in the combined group were higher than those in the control group while PI values were higher in the control group( P< 0. 05). Similarly,no significant difference in FIB,PT,TT and APTT values was observed at baseline( P>0. 05).After treatment,the combined treatment group had higher PT,TT,APTT and lower FIB values than the control group( P<0. 05).Before treatment,there was no difference in NIHSS scores between the two groups( P> 0. 05).Significantly lower NIHSS scores were noticed in both groups after treating for 1 week or 30 days and the combined treatment group showed a more obvious decrease( P< 0. 05). Conclusion Defibrase therapy could improve the coagulation function and blood flow velocity of the middle cerebral artery in patients with acute cerebral infarction.
引文
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[4]邓有琦,左宏,严建东,等.降纤酶治疗急性脑梗塞的疗效及对血浆纤维蛋白原的影响[J].现代生物医学进展,2016,16(5):919-921.
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[10]余晓丹,李铮.丹参多酚酸盐联合降纤酶治疗急性次大面积肺血栓栓塞[J].血栓与止血学,2017,23(1):73-76.
[11]宋卫科,荣阳,邵帅,等.小剂量尼莫通与降纤酶联合治疗急性脑梗死的疗效分析与临床研究[J].中国医药指南,2016,14(1):66-67.
[12]蒋海飞,黄进,等.急性脑梗死降纤治疗出血性转化的危险因素分析[J].中华神经医学杂志,2016,15(1):11-14.
[13]林宝全,阳洪,佘军红,等.降纤酶对急性脑梗死患者血清C反应蛋白、神经功能缺损及凝血时间的影响[J].现代生物医学进展,2016,16(33):6495-6498.
[14]贾宝,韩怀志.降纤酶对急性脑梗死患者血清超敏C反应蛋白、D-二聚体及NIHSS评分和Barthel指数的影响[J].海南医学,2016,27(18):2945-2948.
[15]周才旺,吴国平,杨远征.尤瑞克林联合丁苯酞治疗急性脑梗对神经细胞因子及CXCL16、CD40L的影响[J].海南医学,2017,28(18):3031-3033.
[2]刁晓梁.急性脑梗死患者开展降纤酶联合低分子肝素治疗对其血液流变学及临床疗效的影响探究[J].山西医药杂志,2016,45(6):687-689.
[3]唐思治,包正军,罗霄鹏.降纤酶在改善脑梗死急性期APTTPT及血液流变学指标中的作用[J].河北医学,2016,22(4):566-569.
[4]邓有琦,左宏,严建东,等.降纤酶治疗急性脑梗塞的疗效及对血浆纤维蛋白原的影响[J].现代生物医学进展,2016,16(5):919-921.
[5]Lancet T.Acute myocardial infarction in women[J].Lancet,2016,387(10018):506-506.
[6]李爱美.降纤酶对急性脑梗死患者凝血功能及神经功能的影响[J].国际医药卫生导报,2016,22(17):2662-2664.
[7]张岐平,陈英道,李育英,等.侧支循环的建立对急性脑梗死患者神经功能及预后的影响[J].实用医学杂志,2016,32(7):1040-1043.
[8]李丽媛,王建平.尤瑞克林联合降纤酶对急性脑梗塞患者的神经功能缺损及血浆纤维蛋白原的影响[J].中国地方病防治杂志,2017,34(1):20-21.
[9]狄宝安,刘诗翔,孔繁一,等.降纤酶对脑梗死患者血流动力学的影响[J].西南国防医药,2015,25(1):31-33.
[10]余晓丹,李铮.丹参多酚酸盐联合降纤酶治疗急性次大面积肺血栓栓塞[J].血栓与止血学,2017,23(1):73-76.
[11]宋卫科,荣阳,邵帅,等.小剂量尼莫通与降纤酶联合治疗急性脑梗死的疗效分析与临床研究[J].中国医药指南,2016,14(1):66-67.
[12]蒋海飞,黄进,等.急性脑梗死降纤治疗出血性转化的危险因素分析[J].中华神经医学杂志,2016,15(1):11-14.
[13]林宝全,阳洪,佘军红,等.降纤酶对急性脑梗死患者血清C反应蛋白、神经功能缺损及凝血时间的影响[J].现代生物医学进展,2016,16(33):6495-6498.
[14]贾宝,韩怀志.降纤酶对急性脑梗死患者血清超敏C反应蛋白、D-二聚体及NIHSS评分和Barthel指数的影响[J].海南医学,2016,27(18):2945-2948.
[15]周才旺,吴国平,杨远征.尤瑞克林联合丁苯酞治疗急性脑梗对神经细胞因子及CXCL16、CD40L的影响[J].海南医学,2017,28(18):3031-3033.