不同临床亚型急性脑梗死患者纤维蛋白原水平及三七通舒胶囊的干预研究

Plasma Fibrinogen Level and Effects of Sanqi Tongshu Capsule in Acute Cerebral Infarction

目的观察不同临床类型急性脑梗死(ACI)患者纤维蛋白原水平的变化,分析纤维蛋白原与美国国立卫生研究院卒中量表(NIHSS)评分之间的关系,探讨三七通舒胶囊的干预作用。方法将208例ACI患者按照牛津郡社区卒中计划(OCSP)分型标准分为4大亚型并行NIHSS评分,随机分为治疗组和对照组。治疗组(三七通舒胶囊+疏血通注射液+阿司匹林组)108例,对照组(疏血通注射液+阿司匹林组)100例;检测治疗前后各亚型纤维蛋白原水平变化。结果 OCSP各亚型构成比:完全前循环型(TACI)13.46%、部分前循环型(PACI)30.29%、后循环型(POCI)19.71%、腔隙性梗死型(LACI)36.54%。OCSP分型中TACI、PACI及POCI亚型纤维蛋白原水平升高,LACI变化不明显,与LACI比较,TACI、PACI及POCI有统计学意义(P<0.05)。治疗组OCSP各亚型中TACI、PACI及POCI纤维蛋白原治疗前后比较有统计学意义(P<0.05)。与对照组比较,治疗组治疗14d后TACI、PACI及POCI三亚型纤维蛋白原有统计学意义(P<0.05)。结论三七通舒胶囊可显著降低脑梗死患者的纤维蛋白原水平,可作为脑梗死患者的有效辅助治疗药物。

Objective To investigate the plasma fibrinogen level and the score of American National Institutes of Health stroke scale （NIHSS） in different subtypes of acute cerebral infarction （ACI） and effects of Sanqi Tongshu capsule. Methods Two hundreds and eight patients with ACI were divided into 4 groups based on the criteria of the Oxfordshire Community Stroke Project （OCSP）. All patients were scored by NIHSS and divided into two groups randomly：Treatment group （n 108,Sanqi Tongshu capsule＋Shuxu etong＋aspirin） ,and control group （n： t00, Sanqi Tongshu capsule＋ aspirin）. The plasma fibrinogen was detected before and after treatment. Results The percentage of each ischemic stroke OCSP subtype was as follow：Total anterior circulation infarct 13.46%, partial anterior circulation infarct 30.29 %,posterior circulation infarct 19.71%, and lacunar infarct 36.54 %. The plasma fibrinogen level in TACI,PACI and POCI was increased after cerebral infarction. The level of I.ACI did not significantly change in OCSP. Com pared with the LACI group,the plasma fibrinogen level of TACI, PACI, and POCI were significant difference （P〈0.05）. In TACI, PACI and POCI of treatment group, the plasma fibrinogen level were lowered significantly at the 14th day compared with pretherapy （P〈0.05）. There was a significantly difference of fibrinogen between treatment group and control group in TACI, PACI and POC1 subtypes at the 14th day （P〈0.05）. Conclusion Plasma fibrinogen produced a marked effect on TACI,PACI,and POCI subtypes. Sanqi tongshu capsule could depress the plasma fibrinogen level in ACI,and it was effective for treatment of ACI.