巴曲酶对急性脑梗死患者血浆v WF的影响

EFFECT OF BATROXOBIN ON VON WILLEBRAND FACTOR IN PATIENTS WITH ACUTE CEREBRAL INFARCTION

目的观察巴曲酶对脑梗死患者外周血浆血管性血友病因子（vWF）含量的影响，探讨其对血管内皮细胞功能障碍的临床意义。方法选择68例急性脑梗死患者并随机分为两组。试验组：34例，入院后立即给予巴曲酶10U溶入250mL生理盐水，静脉滴注，1～1．5h滴完；第3、5天各5U，其他用药同对照组；对照组：34例，每日静滴三七总皂甙（商品名：血塞通）0．4g／d和胞二磷胆碱0．5gm；均于治疗前、治疗后第7、14天采用酶联免疫（ELASE）法检测vWF，并对其神经功能缺损进行标准评分。另选取30例健康体检者作为正常组。结果各组vWF水平在不同时存在显著性差异，且以卒中后的第7天最高，随后降低。两组的vwF在治疗前无显著差异，治疗后第7天试验组vWF水平低于对照组（P〈0．05），治疗后第14天无显著性差异（P〉0．05）。两组之间在第l、7天神经功能缺损评分无差异（P〉0．05），第14天有显著性差异（P〈0．01）。结论巴曲酶能降低外周血浆vWF水平，可能是对梗死后的脑血管内皮细胞具有抗粘附、保护内皮细胞的作用。

Objective To investigate the relationship between batroxobin and plasma von- Willebrand factor （vWF） in the patients with acute cerebral infaretion（ACI）. Methods 68 patients with cerebral infarction were divided two groups randomly. The treatment group （n = 34）, were given the dosage 10BU of batroxobin at first time, commonly given at interval of one day with a dosage of 5BU. It should be diluted with 250ml of 0.9 % sodium chloride solution before intravenous influsion for more than 1 hour. Conventional treatment for patients of both groups were the same except for bartroxobin. Patients of the control group were given 0.4g of xuesetong and 0.5g of cytidine diphosphate in 250ml of 0.9 % sodium chloride solution administered by IV instillation q. d. The course of treatment in the two groups lasted 14 days. The neurologie impairment scores were noted down and the level plasma vWF was measured by ELISA before the treatment and on 7th day and 14th day of the treatment. Results The levels of plasma vWF in therapy group were significantly lower than those in ACI routine therapy group on 7th day, Which reached the peak on 7th day and then decreased gradually. The decline of the neurologie impairment scores on 14th day of the treatment group was more striking than that of the control group （ P 〈0.01 ）. There were no significant differeno about neurologic impairment scores on other days. Conclusion Batroxobin can decrease plasma vWF. It can produce the anti-adhereney and protect blood vessel endothelial cells.