纤溶酶对急性脑梗死患者血浆血栓前体蛋白水平的影响及意义

Effects and the significance of fibrinogenase on plasma thrombus precursor protein level in patients with acute cerebral infarction

目的探讨纤溶酶对急性脑梗死(ACI)患者血浆血栓前体蛋白(Tp P)水平的影响及意义。方法 92例病程<72 h的ACI患者随机分为常规药物治疗组(A组,47例)和纤溶酶治疗组(B组,45例)。在治疗前、治疗后24 h、48 h、72 h,采用ELISA法测定血浆Tp P水平,并与43名健康体检者(对照组)比较。采用NIHSS、出院后3个月的日常生活活动能力(ADL)量表评价患者的临床疗效。结果与对照组比较,A、B两组患者治疗前血浆Tp P水平明显升高(均P<0.01)。与A组比较,B组患者治疗后各时间点血浆Tp P水平、NIHSS评分均明显降低(均P<0.05)。与治疗前比较,A、B两组患者治疗后各时间点血浆Tp P水平明显降低;B组患者治疗后各时间点NIHSS评分明显降低(均P<0.05)。A组的ADL评分[(89.87±10.13)分]与B组[(82.16±16.09)分]比较,差异无统计学意义(t=1.870,P=0.067)。但是,B组康复效益大的比例明显高于A组(χ2=5.842,P<0.05)。A、B两组均未见严重不良反应。结论纤溶酶能降低ACI患者血浆Tp P水平,减少神经功能缺损,改善临床预后,且无明显不良反应,值得推广。

Objective To investigate the effects and the significance of fibrinogenase on plasma thrombus precursor protein （TpP） level in patients with acute cerebral infarction （ACI）.Methods Ninety-two ACI patients with the course of disease 〈72 h were divided into conventional drug treatment group （ A group, 47 cases ） and fibrinogenase treatment group （ B group, 45 cases） .The plasma TpP level was detected by ELISA method before and 24 h, 48 h, 72 h after treatment.And the results were compared with those of 43 healthy controls （control group）. The clinical efficacy was evaluated by NIHSS and activities of daily life （ ADL） scores at 3 months after treatment. Results Compared with the control group, the plasma TpP levels of A and B groups before treatment were significantly increased （ all P〈0.01） .Compared with the A group, the plasma TpP levels and the NIHSS scores of B group at each time point after treatment were significantly decreased （ all P〈0.05 ） . Compared with before treatment, the plasma TpP levels of A and B groups at each time point after treatment were significantly decreased, and the NIHSS scores of B group at each time point after treatment were significantly decreased （all P〈0.05）.The ADL score of A group （89.87 ±10.13） compared with B group （82.16 ±16.09） had no significantly difference. The rate of high rehabilitation efficiency in B group was significantly higher than that in A group （χ2 =5.842,P〈0.05）.A, B two groups had no serious adverse reactions.Conclusions Fibrinogenase can depress the plasma TpP level of ACI patients, reduce the neurological impairment and improve the clinical outcomes.It has no obvious adverse reactions, which is worth promoting.