巴曲酶治疗急性脑梗死纤维蛋白原含量的动态变化及与再梗死的关系

STUDY ON THE DYNAMIC CHANGES OF FIB AFTER APPLYING BATROXOBIN IN ACI PATIENTS AND THE RELATIONSHIPS BETWEEN FIB LEVEL AND REINFARCTION

目的：探讨巴曲酶治疗急性脑梗死后血浆纤维蛋白原（FIB）含量的动态变化及与再梗死的关系。方法：选择2001年12月至2003年12月于我院就诊的急性脑梗死患者90例，随机分为3组。治疗组、特殊对照组、常规对照组。在应用巴曲酶治疗前、治疗后第7天、第14天进行血液相关指标的检测及脑CT扫描。结果：治疗组在治疗后第7天血FIB水平与治疗前相比明显下降（P〈0．01），治疗后第14天FIB明显回升至治疗前水平，甚至高于用药前水平；治疗组30例患者中有3例于14天～21天出现了再梗死。发生再梗死的患者其FIB水平均明显高于正常范围。特殊对照组在治疗后第7天血FIB水平与治疗前相比也明显下降（P〈0．01），在治疗后第14天仍维持较低水平#而常规对照组在治疗前后血FIB水平无明显变化（P〉0．05）；特殊对照组和常规对照组均未出现再梗死病例。治疗组治疗后脑CT扫描梗塞灶体积明显小于治疗前（P〈0．05），与特殊对照组治疗后相比无明显差别（P〉0．05），但明显小于常规对照组（P〈0．05）。结论：巴曲酶治疗脑梗死过程中降低FIB血浆浓度后又有反弹导致FIB浓度增高。与再梗死有一定的关系，在临床上应引起高度重视。

Objective： To study the dynamic changes of fibrinogen （FIB） after applying batroxobin in acute cerebral infarction （ACI） patients and the relationships between FIB level and reinfarction. Methods, 90 ACI patients was collected in this study and divided into 3 groups at random; batroxobin therapy group, plasmin contrast group （special contrast group）, troxerutin contrast group （routine contrast group）. The FIB level in blood was detected and brain was scanned by CT before treatment, 7 days, 14 days after treatment respectively. Results： In batroxobin therapy group, 7 days after treatment the FIB level was decreased significantly compared with pretherapy （P〈0. 01） ; 14 days after treatwent the FIB level returned to pretherapy and even higher than pretherapy. Among the 30 patients in batroxobin therapy group 3 patients refarctioned 14-21 days after treatment and their FIB level obviously higer than normal. In special contrast group,the FIB level decreased significantly compared with pretherapy （P〈0. 01）, and sustained low level 14 days after treatment. In routine contrast group, the FIB level had no obvious changes before and after treament （P〉0.05）. It had no refarctioned patients both in special contrast group and routine contrast group. The infarct volume after treatment in batroxobin therapy group was obviously smaller than pretherapy （P〈0. 05）, and had no remarkable difference with special control group after treatment. Conclusion. In curing ACI patients batroxobin can decrease the FIB level at first and increase it after certain time. Batroxobin has certain rlationships with refraction, and this should evoke our attention in clinical.