尤瑞克林治疗不同TOAST亚型脑梗死的疗效

Efficacy of urinary kallidinogenase acts on different sub-types of cerebral infarction classified by TOAST criteria

目的研究尤瑞克林对低分子肝素治疗急性卒中试验(TOAST)不同亚型患者的治疗作用。方法将193例住院治疗的急性脑梗死患者随机分为对照组(n=95)和尤瑞克林组(n=98),两组患者在血管评估的基础上均按TOAST分型分为L、S、C、O、U等亚型,对照组给予常规抗血小板、调脂、改善循环及防治并发症等治疗,尤瑞克林组在常规治疗的基础上给予尤瑞克林0.15 PNA·d-1,共14 d。治疗前后对美国国立卫生院神经功能缺损评分(NIHSS评分)和改良残障水平评定量表(mRS评分)进行比较。结果治疗14 d后,尤瑞克林组NIHSS评分及mRS评分改善更为显著,与对照组相比有显著差异(P<0.05);与对照组相应亚型相比,尤瑞克林组L、C、O亚型的评分改善更为显著(P<0.05),而S、U亚型无显著改变(P>0.05)。尤瑞克林组L亚型的显效率和总有效率最高(P<0.05)。结论尤瑞克林对L、C、O型脑梗死有良好的治疗作用,尤其对L亚型脑梗死最有效。

AIM To investigate the efficacy of urinary kallidinogenase on different sub-types of acute cerebral infarction （AC1） according to the Trial of Org 10172 in Acute Stroke Treatment （TOAST） criteria. METHODS One hundred and ninety-three patients hospitalized with ACI were randomly divided into control group （n = 95） and urinary kallidinogenase treatment group （n = 98）. All patients were divided into different sub-types as L, S, C, O, U subtypes according to TOAST classification on the basis of the cerebral vascular evaluation. Besides the treatment of urinary kallidinogenase 0.15 PNA·d^-1 in the treatment group for 14 days, both groups were treated with anti- platelet drugs, lipid- lowering drugs, traditional chinese drugs, and the prevention of complications. The degrees of neurologic impairment of all the patients were observed and evaluated by the National Institute of Health stroke scale （NIHSS） and the 3-month modified Rankin scale （mRS） before and after the treatment. RESULTS The nerve functional recovery occurred in the treatment group with significant difference on NIHSS score and mRS score than the control group （P 〈 0.05）. Compared with the corresponding subgroup in control group, NIHSS score and mRS score of L, C, O subtypes improved more significant （P 〈 0.05）, while the S, U subtypes did not change significantly （P 〉 0.05）. And L subtype in the treatment group had the highest efficiency and total efficiency （P 〈 0.05）. CONCLUSION Urinary kallidinogenase can significantly improve the clinical outcome of patients in L, C, O subtypes of cerebral infarction classified by TOAST criteria, especially in the L subtype.