尿激酶联合复方丹参注射液治疗急性脑梗死的综合评价

Comprehensive Evaluation of Urokinase Combined with Salvia Miltiorrhiza Injection for Acute Cerebral Infarction

目的:探讨尿激酶联合复方丹参注射液治疗急性脑梗死的疗效和安全性。方法:选取本院收治的急性脑梗死患者178例,以单盲法随机分为观察组和对照组各89例;两组患者均行扩血管、降压、抗血小板等基础疗法,对照组在此基础上进行尿激酶溶栓治疗,观察组在对照组基础上追加复方丹参注射液静脉滴注;对比两组患者治疗前后的NIHSS和ADL评分,并结合患者血液流变性、血清氧化应激水平及并发症发生情况分析其疗效和安全性。结果:治疗前,两组患者的ESS、NIHSS评分,血液流变性及血清氧化应激水平均无显著差异(P>0.05)。治疗后,观察组患者的NIHSS评分显著低于对照组(P<0.05),ADL评分显著高于对照组(P<0.05);全血黏度、血浆黏度、红细胞比容、血小板黏附率等血液流变性指标,以及8-OHdG、MDA等氧化应激指标显著低于对照组(P<0.05);而抗氧化应激指标SOD显著高于对照组(P<0.05)。观察组出现颅内出血2例、消化道出血2例、腹泻9例,对照组相应比例为3例、2例、11例,两组患者的并发症发生率无显著差异(P<0.05)。结论:尿激酶联合复方丹参注射液治疗急性脑梗死可显著提高患者的抗氧化应激能力,利于稳定血管内皮功能;同时,能够有效改善患者血液流变性,加强脑部供血,对于减小梗死面积和保护神经功能均有良好疗效;且无明显不良反应,安全、可靠。

Objective ： To investigate the efficacy and safety of urokinase combined with salvia mihiorrhiza injection to treat acute cerebral infarction. Methods： 178 cases of patients with acute cerebral infarction were selected and randomly divided into two groups by single - bland experiment. All patients were given basic treatment of ascular dilation, intracra- nial pressure reduction, antiplatelet therapy, etc; on the basis of which 89 cases of control group were given urokinase while 89 cases of Observation group were given both urokinase and salvia mihiorrhiza injection. Levels of ESS and NIHSS score, blood rheological property, oxidative stress markers as well as complications were investigated comprehensively to analyze the efficacy and safety contrastively. Results ： Before treatment, there was no difference in all indexes of ADL score, NIHSS score, blood rheological property, and oxidative stress level （P 〉 0.05） between groups. After treatment, the ADL score of patients in observation group were significantly lower while the NIHSS scores were significantly higher than that in control group （ P 〈 0.05 ） ; the blood rheology indexes of whole blood viscosity, plasma viscosity, erythrocyte hematocrit, and platelet adhesion rate, as well as the oxidative stress indexes of 8 - OHdG and MDA were all significantly lower （P〈0.05） while the antioxidant index of SOD was significantly higher than that in control group （P 〈 0.05 ）. There was no significant difference in complication incidence between groups （ P 〈 0.05 ） with 2 cases of intracranial hemorrhage, 2 cases of gastrointestinal bleeding, 9 cases of diarrhea in observation group and 3 cases of intracranial hem- orrhage, 2 cases of gastrointestinal bleeding, 11 cases of diarrhea in control group. Conclusion ： We conclude that it is ef- ficient and reliable for urokinase combined with salvia mihiorrhiza injection to treat acute cerebral infarction which con- tributes to stable vascular endothelial function as well as improving brain blood flow with abilities of oxidation resistanceand rheology majorization.