尤瑞克林治疗急性脑梗死的效果及磁共振波谱分析研究

Therapeutic Effect of Human Urinary Kallidinogenase on Patients with Acute Cerebral Infarction and Study of Magnetic Resonance Spectrum

目的:观察尤瑞克林治疗急性脑梗死效果及磁共振波谱特征,探讨尤瑞克林可能的作用机制。方法:发病在24 h内的急性脑梗死患者76例,随机数字表法及随机数余数法分为治疗组38例和对照组38例,对照组接受常规治疗,治疗组在常规治疗的基础上加用尤瑞克林。两组患者均于治疗前、治疗15 d后进行神经功能缺损程度评分及BARTHEL指数评定,并应用磁共振波谱分析入院时(治疗前)、治疗15 d后脑内N-乙酰天门冬氨酸(NAA)和乳酸(Lac)含量。结果:治疗组治疗15 d的神经功能缺损程度评分低于对照组,BARTHEL指数评分高于对照组,比较差异有统计学意义(P<0.01)。磁共振波谱分析显示,治疗后治疗组局部Lac含量低于对照组,NAA含量高于对照组,比较差异有统计学意义(P<0.01)。结论:急性脑梗死患者采用尤瑞克林治疗能够显著改善临床预后,其作用机制可能与加速梗死区Lac清除有关。

To observe the therapeutic effect of human urinary kallidinogenase on patients with acute cerebralinfarction（ACI）and the features of magnetic resonance spectrum（MRS）,to explore the potential mechanism of action of human urinary kallidinogenase. Method：This study consisted of 76 patients with ACI occurred within 24 h, who were randomized to treatment group and control group. A conventional therapy was offered to patients in the control group;to those in the treatment group,conventional therapy plus human urinary kallidinogenase were offered. Neurologic impairment and BARTHEL were assessed pretherapy and 15 days after therapy. The content of N-acetylaspartate and lactic acid were analyzed by using MRS before and 15 days after treatment. Result：After 15 days of treatment,the score of neurologic impairment was lower in the treatment group than that in the control group,and the BARTHEL index was higher （P〈0.01）. The MRS showed that after therapy,the level of lactic acid in the treatment group was lower than that in the control group,and N-acetylaspartate was higher（P〈0.01）. Conclusion：Human urinary kallidinogenase can notably improve the prognosis of patients with ACI,its mechanism is likely to be associated with accelerating clearance of lactic acid in infarct zone.