外源性激肽原酶对溶栓时间窗外急性脑梗死患者VEGF和IL-6表达的影响及临床意义

The Effect and Clinical Significance of Exogenous Kininogenase on Serum VEGF and IL-6 in Patients with Acute Cerebral Infarction in Time of Non Thrombolytic Time Window

目的观察外源性激肽原酶对溶栓时间窗外急性脑梗死患者血清血管内皮生长因子(VEGF)和白细胞介素6(IL-6)的影响,探讨其临床意义。方法用临床随机对照的观察方法,将40例急性脑梗死患者按随机数字表法将入院的时间窗外急性脑梗死患者随机分为灯盏细辛对照组和外源性激肽原酶治疗组,每组均为20例。两组均采用常规治疗。外源性激肽原酶治疗组在常规治疗的基础上选用外源性激肽原酶,用外源性激肽原酶0.15PNA单位,加生理盐水100mL,静注30min,每日1次;对照组在常规治疗的基础上用灯盏细辛30mg,加生理盐水250 mL静滴,每日1次;治疗组和灯盏细辛对照组疗程均为14d。治疗组用药前24h及用药期间禁用血管紧张素转换酶抑制剂。观察1个疗程。分别在治疗前和治疗后7d和14d检测血清VEGF和IL-6水平。结果治疗组治疗后第7d和14d溶栓时间窗外急性脑梗死患者血清VEGF水平明显增加及IL-6水平明显减少,与对照组比较差异有显著性(P<0.05)。结论外源性激肽原酶能增加血清VEGF及减少IL-6水平来改善溶栓时间窗外急性脑梗死患者缺损的神经功能。

Objective To observe influence of exogenous kininogenase on serum vascular endothelial growth factor（VEGF） and interleukin 6（IL-6） in patients with acute cerebral infarction in time of non thrombolytic time window and to explore its clinical signifi cance.Methods with clinical randomized controlled observation method,40 cases were randomly divided into the control group of Erigeron breviscapus and exogenous kininogenase treatment group and 20 cases in each group.Two groups were given routine treatment.based on the conventional treatment,the cases of exogenous kininogenase treatment group were used exogenous kallikrein 0.15 PNA units and saline injection 100 ml,with intravenous injection in 30 min,1 times a day.based on the conventional treatment,the cases of control group were used Erigeron breviscapus 30mg and saline injection 250 ml,1 times a day.The period of treatment of two groups was 14 days.In 24h before and during the treatment period,angiotensin converting enzyme were inhibited.Before treatment and after 7d and 14d of reatment,serum VEGF and IL-6 levels were detected.Results Compared with the control group,serum VEGF levels of treatment group patients were signif icantly increased and IL-6 levels were signif icantly reduced after treatment of 7d and 14d and there were signif icant differences（P0.05）.Conclusions Exogenous kininogenase can increase the serum VEGF and decrease IL-6 level of treatment group patients to improve neural function defect of acute cerebral infarction patients.