阿司匹林、巴曲酶联合低分子肝素治疗急性脑梗死的临床研究

Clinical study of aspirin batroxobin combined with low-molecular-weight heparin in patients with acute cerebral infarction

目的:探讨阿司匹林(ASA)、低分子肝素(LMWH)及巴曲酶(DF-521)联合应用对脑梗死急性期的疗效及安全性。方法:将101例急性脑梗死患者随机分成阿司匹林与巴曲酶联合治疗组(对照组,n=51)和阿司匹林、巴曲酶联合低分子肝素治疗组(观察组,n=50),观察治疗前后血液流变学指标的变化,随访3个月,比较两组治疗前15、30、90天的美国国立卫生研究院卒中量表(NIHSS)评分、日常生活能力指数(BI)评分。结果:两组患者治疗后血液流变学指标比治疗前均有明显降低,差异有统计学意义(P<0.05)。两组对高切应力和红细胞压积的影响差异有统计学意义(P<0.05),观察组好于对照组。三联治疗组在治疗后90天时NIHSS、BI评分的好转优于两联治疗组,差异有统计学意义(P<0.05)。出血发生情况两组差异无统计学意义。结论:阿司匹林、巴曲酶和低分子肝素联合治疗可明显改善脑梗死患者神经功能缺损症状,改善预后,且安全性好。

Objective： To investigate the therapeutic efficacy of aspirin, batroxobin combined with low-molecular-weight heparin on the acute cerebral infarction and to evaluate the safety of the three drugs. Methods： 101 cases with acute cerebral infarction were randomly devided into two groups：（1）50 cases were treated with batroxobin, low-molecular-weight heparin combined with aspirin;（2） 51 cases were given batroxobin and aspirin. Blood viscosity was estimated before and after treatment. The scores of NIHSS,Barthel were estimated before and 15 and 30 and 90 days after treatment. Results： In these two groups , plasma fibrinogen, high shear rate and hematocrit were decreased after the therapy （P〈0.05）.The decreases of high shear rate and hematocrit were more improved in aspirin , batroxobin combined with low-molecular-weight heparin therapy group than those in aspirin plus batroxobin therapy group.The significant statistical difference was found （P〈0.05）. 90 days after the therapy.The scores of NIHSS,Barthel were more improved in aspirin, batroXobin combined with low-molecular-weight heparin therapy group than those in aspirin plus batroxobin therapy group. The significant statistical difference was found （P〈0.05）. There was no statistical difference in systemic hemorrhage in those two groups. Conclusion： Aspirin, batroxobin combined with low-molecular-weight heparin therapy may be beneficial to restoring the nervous function. It can improve the prognosis and be safety.