蚓激酶治疗急性脑梗死的疗效及其对脑血流动力学的影响

Effectiveness of Lumbrokinase in the treatmengt of acute cerebral infarction and its influence to cerebral haemedynamic

目的观察和研究蚓激酶胶囊治疗急性脑梗死患者的疗效及对脑循环动力学的影响。方法回顾性分析2009年12月~2011年4月在我院住院治疗的82例急性脑梗死患者临床资料,采用蚓激酶胶囊2粒/次,3次/d,饭前半小时口服,丹参注射液250 mL,静脉滴注,1次/d,肠溶阿司匹林100 mg,1次/d,口服,连续15 d治疗。对治疗前后的脑神经功能缺损评分、血液流变学、脑循环动力学参数（CVDI）、血管活性物的变化等进行对比。结果①82例患者中有75例病情均有不同程度改善,总有效率为91.46%;②神经功能缺损评分,蚓激酶胶囊治疗前[（10.85±3.26）分]与治疗后[（5.04±1.89）分]相比,差异有高度统计学意义（P〈0.01）;③患者经治疗后全血黏度、血浆黏度、红细胞聚集指数、红细胞变形指数均显著低于治疗前,差异有统计学意义（P〈0.05）;④蚓激酶用药后与用药前比较,颈内动脉（ICA）、椎动脉（VA）的峰值流速（VP）、阻力指数（RI）、加速时间（AT）所得数值明显降低（P〈0.05、P〈0.01）;⑤蚓激酶治疗前后血浆TXB2、6-K-PGF1a含量、CGRP/ET、6-K-PGF1a/TXB2比值差异有统计学意义（P〈0.05、P〈0.01）。结论蚓激酶胶囊治疗急性脑梗死患者疗效好,能明显改善脑血流灌注,降低脑循环阻力,减少神经功能缺损,从而达到治疗脑梗死的目的,作为脑梗死的治疗药物安全有效。

Objective To observe and explore the curative effect of Lumbrokinase in the treatment of acute cerebral infarction and its influence to cerebral haemedynamic.Methods The clinical datas of 82 patients with acute cerebral infarction in the hospital who were collected from December 2009 to Aprol 2011 had been retrospective analyzed.The therapeutic schedule was that 2 Lmbrokinase capsules should be taken before meal,3 times a day,Salvia Miltiorrhiza Injection was dripped in vein once a day and 100 mg Intestines Dissolving Aspirin Orally was given once a day for 15 days.The changes of cranial nerve function defect score,hemorheology,CVDI,and vasoactivesubstance were measured before and after the treatment.Results ①The conditions of 75 cases were improved,the total effective rate achieved for 91.46%.②The nerve function defect score were（10.85±3.26） scroses before treatment which had the statistically significant compared with after treatment [（5.04±1.89） scroses]（P 0.01）.③Whole blood viscosity,plasma viscosity,RBC aggregation index and RBC deformed exponent of patients after treatment were all remarkably lower than those before treatment（P 0.05）.④Compared to before the medication,the VP,RI and AT of ICA and VA after treatment were obviously decreased（P 0.05、P 0.01）.⑤Compared to before the medication,the content of TXB2、6-K-PGF1a of blood plasma and CGRP/ET、6-K-PGF1a/TXB2 had significant difference than that of after treatment（P 0.05、P 0.01）.Conclusion It has a good effectiveness to treating acute cerebral infarction with Lumbrokinase.It can improve cerebral blood flow,reduce cerebral circulation resistance,and also can decrease nerve function defect so as to treat cerebral infarction.As the drug of cerebral infarction,Lmbrokinase is safety and effective.