巴曲酶治疗时间对急性脑梗死患者脑血管储备功能的影响

Effect of Batroxobin Treatment Time on the Cerebrovascular Reserve Function in Patients with Acute Cerebral Infarction

目的 探讨巴曲酶治疗时间对急性脑梗死患者脑血管储备功能的影响。方法 选取2011年12月至2013年12月于成都市第六人民医院就诊的脑梗死患者40例,将其按照抽签法随机分为观察组和对照组,各20例。观察组入院即采用巴曲酶干预治疗,将0.25~0.5 U巴曲酶混合在10 m L的0.9%Na Cl注射液中注射,而后每日肌内注射1 U巴曲酶,维持治疗4周。对照组先采用西医常规治疗,将30 mg依达拉奉完全溶解在适量0.9%Na Cl注射液中静脉滴注,30 min内滴完,每日2次,1周后再应用巴曲酶治疗,巴曲酶用法与观察组一致。对比观察两组患者的临床治疗效果及患者脑血管储备功能。结果 治疗后观察组患者纤维蛋白原水平、全血高切黏度、全血低切黏度、血细胞比容、血浆黏度低于对照组[（0.032±0.009）g/L比（0.005±0.001）g/L,（3.89±0.40）m Pa·s比（6.02±0.35）m Pa·s,（15.31±4.49）m Pa·s比（18.93±4.26）m Pa·s,（37.02±4.62）%比（46.31±6.23）%,（1.35±0.16）m Pa·s比（2.27±0.29）m Pa·s]（P〈0.05或P〈0.01）。结论早期应用巴曲酶干预治疗能保护脑梗死患者的脑部屏障,帮助恢复神经元功能,提升患者脑血管储备功能,值得临床推广。

Objective To investigate the effect of batroxobin in the treatment of cerebral vascular reserve time function in patients with acute cerebral infarction. Methods Total of 40 patients with cerebral infarction admitted to Chengdu Sixth People＇s Hospital from Dec. 2011 to Dec. 2013 were included in the study and divided into treatment group and control group according to the lottery method ,20 cases each. The observation group received batroxobin intervention： 0. 25-0. 5 U of batroxobin mixed in 10 mL of 0. 9% NaCl for injection as the starting dosage ,then daily intramuscular injection of 1 U batroxobin for 4 weeks. The con- trol group adopted routine western medicine ：30 mg edaravone completely dissolved in an appropriate amount of 0. 9% NaCl injection for intravenous drip, completed within 30 min, twice a day, a week later was also given batroxobin with same usage as the observation group. The clinical therapeutic effect and Cerebrovascular reserve function of the two groups were compared. Results After treatment, fibrinogen, high shear whole blood viscosity,low shear whole blood viscosity, hematocrit, plasma viscosity of the observation group were lower than the control group [ （0. 032 ± 0. 009 ） g./L vs （0. 005 ± 0. 001 ） g/L, （3.89 ± 0. 40 ） mPa·s vs （6.02±0.35） mPa. s,（15.31 ±4.49） mPa· s vs （18.93 ±4.26） mPa·s,（37.02 ±4.62）% vs （46.31±6.23）%,（1.35 ±0.16） mPa. s vs （2.27 ±0.29） mPa·s] （P 〈0.05 or P 〈0.01）. Conclusion Batroxobin intervening treatment can effectively protect the brain barrier of patients with cere- bral infarction,to better promote the neuronal recovery and improve the cerebral vascular reserve function, thus is worthy of clinical promotion.