水蛭地龙提取液治疗急性脑梗死的作用机制及疗效

The efficacy and mechnisam of extract liquor from hirudo and earthworm for patients with acute cerebral infarction

目的探讨水蛭地龙提取液(extractliquorfromhirudoandearthworm,ELHE)治疗急性脑梗死的作用机制及疗效。方法78例急性脑梗死患者被随机分为2组:对照组38例,进行基础治疗;治疗组40例,在基础治疗的同时静脉给予ELHE(20ml+等渗盐水250ml,静脉滴注,1次/d,连续2周)。观察2组脑梗死患者治疗前、后神经功能评分、Barthel指数及活化部分凝血活酶时间(APTT)、血浆凝血酶原时间(PT)、组织型纤溶酶原激活物(tPA)、纤溶酶原激活物的抑制剂(PAI1),以及血栓烷B2(TXB2)、6酮前列腺素(6KetoPG)Flα的变化。结果ELHE组患者经过14d治疗,其神经功能缺失评分由9.4±4.0下降为3.3±1.2,Barthel指数由25.9±4.6升高为67.4±2.8,APTT、PT分别由(28.2±3.8)s、(12.2±3.5)s延长为(42.0±5.2)s、(19.5±2.1)s,血浆tPA含量及活性分别由(10.1±1.2)μg/L、(0.27±0.03)KIU/L升高为(15.3±2.1)μg/L、(0.57±0.12)KIU/L,血浆PAI1含量及活性由(47.8±4.6)μg/L和(0.77±0.12)KAU/L下降为(44.2±3.0)μg/L和(0.68±0.11)KAU/L,血栓烷B2由(228.4±48.9)ng/L降低为(152.7±44.4)ng/L,6KetoPGF1a由(21.9±6.3)ng/L升高为(33.8±6.4)ng/L,与对照组比较差异均有显著意义(P<0.05)。结论ELHE具有明显抗凝、促纤溶、抑制血小板聚集,改善血液循?

Objective To investigate the efficacy and mechanism of extract liquor from hirudo and earthworm(ELHE) on treatment for patients with acute cerebral infarction. Methods 78 cases of patients with acute cerebral infarction were treated with conventional therapy. Among them, 40 cases group were added infusion of ELHE and the rest 38 patients were as control group.The changes of Neurological functional deficit scores, Barthel index (BI), APTT, PT, tPA, PAI-1, TXB2, and 6-Keto-PGF1a were observed between two groups before and after treatment. Results Compared with the control group after 14 days, the value of Neurological functional deficit scores were decreased from 9.4 ± 4.0 to 3.3 ± 1.2. The content and vitality of PAI-1 were reduced from(47.8 ± 4.6)μg/L and(0.77 ± 0.12)KAU/L to(44.2 ± 3.0)μg/L and(0.68 ± 0.11)KAU/L respectively, and the TXB2[from(228.4 ± 48.9)ng/L to(152.7 ± 44.4)ng/L]were remarkably reduced in ELHE group, while the amounts of Barthel index(from 25.9 ± 4.6 to 67.4 ± 2.8). The content and vitality of tPA were reduced from(10.1 ± 1.2)μg/L and(0.27 ± 0.03)KAU/L to(15.3 ± 2.1)μg/L and(0.57 ± 0.12)KAU/L respectively. The 6-Keto-PGF1a was elevated from(21.9 ± 6.3) ng/L to(33.8 ± 6.4)ng/L and the APTT(from 28.2 ± 3.8 to 42.0 ± 5.2), PT(from 12.2 ± 3.5 to 19.5 ± 2.1) were remarkabaly prolonged. There were significant difference between two groups(P < 0.05). Conclusion ELHE is effective and safe on protection and treatment for acute cerebral infarction, for it may accelerat fibrinolysis,anticoagulation, inhibit aggregation of platelets, and improve blood circulationin of the patients.