降纤酶与右旋糖酐-40治疗急性脑梗死的比较

Defibrase vs dextran- 40 in treating acute cerebral infarction

目的：比较降纤酶与右旋糖酐＿４０治疗急性脑梗死的疗效及其安全性。方法：经ＣＴ证实的急性脑梗死５８例，分为２组，均用常规治疗（脑活素、甘露醇），降纤酶组３２例，加用降纤酶１０ＩＵ（ｄ１～３），５ＩＵ（ｄ４～６）各溶于０．９％氯化钠注射液２５０ｍＬ中静脉滴注（静滴），共用６ｄ；右旋糖酐组２６例，加用右旋糖酐＿４０，５００ｍＬ，静滴，ｑｄ，共用７～１４ｄ。结果：降纤酶组用药２４ｈ内起效１２例，快于右旋糖酐组（２例），Ｐ＜０．０５；２组治疗４ｗｋ的总有效率降纤酶组８４％略高于右旋糖酐组（６９％），Ｐ＞０．０５。降纤酶有非常显著的降低凝血因子Ｉ、血小板最大聚集率、血细胞比容和血栓指数Ｑ值的作用（Ｐ＜０．０１），且无明显不良反应。结论：降纤酶治疗急性脑梗死优于右旋糖酐＿４０。

AIM: To compare the efficiency and safety of defibrase and dextran-40 in treating acute cerebral infarction (ACI). METHODS: Fifty-eight patients with ACI under conventional treatment (Cerebrolysin, mannitol) were divided into 2 groups. Thirty_two patients were injected with defibrase 10 IU in 0.9% sodium chloride 250 mL, iv, drip qd×3 d, 5 IU qd×3 d, 6 d as a course. Twenty_six patients were injected with dextran_40, 500 mL, iv drip qd×(7_14) d, as a course in control group. RESULTS: Therapeutic effects appeared within 24 h in 12 patients of the defibrase group, but only 2 patients of dextran group (P<0.05). The total effective rates within 4 wk in defibrase group were 84% and 69% in the dextran group (P>0.05). The defibrase group showed noticeable effects in reducing hageman factor I, platelet aggregation second phase (PAG max), hematocrit, and thrombus index Q (P< 0.01). No adverse reactions were found. CONCLUSION: Defibrase is better than dextran_40 for the treatment of ACI.