舒血宁注射液对缺血性脑卒中患者血液流变学及生化指标的影响

Effect of Shuxuening Injection on Hemorheological and Biochemical Indexes in Patients with Ischemic Stroke

目的探讨舒血宁注射液对缺血性脑卒中患者血管性血友病因子（vWF）、血小板活化因子（PAF）、脂蛋白相关磷脂酸A_2（LpPLA_2）水平的影响。方法选取2014年6月至2015年6月医院收治的缺血性脑卒中患者60例,随机分为对照组和观察组,各30例。两组患者均接受科学的治疗和康复训练,对照组给予阿司匹林,观察组在对照组基础上加用舒血宁注射液,每次2-4 mL,每日1-2次,静脉滴注。两组均连续治疗4周。比较两组治疗后血液流变学指标和生化指标的变化情况,记录两组治疗期间不良事件发生情况。结果观察组颅内出血、症状性颅内出血发生率和死亡率均低于对照组,但组间差异无统计学意义（P〉0.05）;观察组发生总不良事件发生率明显低于对照组（P〈0.05）;治疗后,观察组神经功能缺损（SSS）评分明显低于对照组（P〈0.05）;观察组的血液流变学指标、vWF、PAF、Lp-PLA_2、超敏C反应蛋白（hs-CRP）的水平均明显低于治疗前,且观察组明显低于同期对照组（P〈0.05）;两组患者不良反应发生率无明显差异（P〉0.05）,且均未发生血、尿常规肝肾功能和凝血4项异常;1年的随访结果表明,观察组患者的复发率明显低于对照组（P〈0.05）。结论舒血宁注射液有改善脑部微循环、阻止颅内动脉血栓的形成,并有抑制vWF,PAF,Lp-PLA_2的表达等作用,值得临床推广。

Objective To explore the effect of Shuxuening Injection on the levels of vWF,PAF,Lp-PLA_2 in patients with cerebral ischemic stroke.Methods 60 cases of ischemic stroke patients from December 2014 to October 2012 were randomly divided into the control group and the observation group 30 cases in each group.The two groups were treated with scientific treatment and rehabilitation training;the control group was given aspirin,and on the basis of the control group,the observation group was treated by Shuxuening Injection,2-4 mL/time,1-2 times/d,intravenous drip.The adverse events,blood flow index and biochemical index of the two groups were recorded before and after treatment.Results The numbers of intracramal hemorrhage,symptomatic intracranial hemorrhage rate and death rate in the observation group were lower than those in the control group,but the difference was not statistically significant（P〉0.05）.The total adverse events in the observation group were significantly lower than the control groupV P〈0.05）.There was no difference in SSS score before treatment,after treatment,the observation group was significantly lower than the control group（P〈0.05）.The blood flow index,vWF,PAF,Lp-PLA2,hs-CRP and in the observation group after treatment were significantly lower than before treatment and the control group after treatment（P〈0.05）.After treatment,there was no difference in the proportion of adverse reactions in the two groups（P〉0.05）.No abnormal on blood,unne routine,liver and kidney function and blood coagulation.The followup results of 1 years showed that the recurrence rate of the observation group was significantly lower than that of the control group（P〈0.05）.Conclusion Shuxuening Injection can improve cerebral microcirculation and prevent the formation of intracranial arterial thrombi,and has the effect of inhibiting the vWF and PAF,Lp-PLA_2 expression,which is worthy of clinical promotion.