血栓通注射液与阿司匹林对急性复发性脑梗死的临床研究

Clinical trial of Xueshuantong injection combined with aspirin in patients with recurrent acute cerebral infarction

目的观察血栓通注射液与阿司匹林治疗急性复发性脑梗死的临床疗效及其对血管内皮生长因子(VEGF)血清水平的影响。方法 80例急性复发性脑梗死患者分为试验组40例与对照组40例。在常规治疗的基础上,对照组给予阿司匹林100 mg pid,口服;试验组在对照组的基础上给予血栓通注射液500mg,每天1次,静脉滴注,2组均连续治疗14 d。观察2组患者的临床疗效,比较2组患者的血流动力学指标变化情况、血栓调节蛋白(TM)、组织纤溶酶原激活物抑制物(PAI)、组织纤溶酶原激活物(t-PA)及D-二聚体(D-dimer)水平及VEGF水平。结果治疗后,试验组总有效率为92.50%(37/40例),对照组为82.50%(33/40例,P>0.05)。治疗后,试验组患者全血高切黏度(5.45±0.78)mPa·s,血浆高切黏度(1.87±1.33)mPa·s,对照组全血高切黏度为(5.91±0.24)mPa·s,血浆高切黏度为(2.20±3.09)mPa·s,差异有统计学意义(P<0.05)。治疗后,试验组TM为(35.36±8.14)ng·mL^(-1),PAI为(0.73±0.30)AU·mL^(-1),t-PA为(1.97±0.18)U·mL^(-1),D-二聚体为(0.42±0.28)mg·L^(-1);对照组TM为(39.50±10.25)ng·mL^(-1),t-PA为(1.35±0.14)U·mL^(-1),D-二聚体为(0.43±0.24)mg·L^(-1),2组较治疗前差异有统计学意义(P<0.05)。试验组t-PA与对照组比较,差异有统计学意义(P<0.05)。试验组治疗3,7,14 d的VEGF水平分别为(320.24±45.63),(436.33±35.84),(398.31±46.60)ng·L^(-1),对照组分别为(370.41±39.52),(542.72±68.00),(352.72±49.80)ng·L^(-1),2组差异有统计学意义(P<0.05)。所有患者治疗中均未出现药物不良反应,安全性良好。结论血栓通注射液与阿司匹林治疗急性复发性脑梗死疗效显著,血栓通注射液能够有效改善患者血清VEGF水平。

Objective To observe the clinical effect of thrombus injection combined with aspirin in the treatment of acute recurrent cerebral infarction and its effect on serum level of vascular endothelial growth factor（VEGF）.Methods Eighty cases of acute recurrent cerebral infarction were divided into treatment group and control group,40 cases in each group.On the basis of conventional treatment,control group was treated with aspirin 100 mg.Treatment group was treated with Xueshuantong 500 mg,1 time a day intravenous injection on the basis of control group.All patients were treated 14 d.To observe the clinical effect of the two groups,the hemodynamic changes of thrombomodulin（TM）,tissue plasminogen activator inhibitor（PAI）,tissue plasminogen activator（t-PA） and D-dimer levels and the level of VEGF were compared.Results After treatment,the total effective rate of treatment group was 92.50%（37/40）,had significant difference with that in control group,which was 82.50%（33/40,P〉0.05）.After treatment,the high shear viscosity of whole blood,plasma high shear viscosity in treatment group were（5.45 ± 0.78）,（1.87±1.33） mPa·s.And high shear viscosity of whole blood,plasma high shear viscosity in control group were（5.91 ± 0.24）,（2.20 ± 3.09） mPa · s（P〈0.05）.After treatment,the TM,PAI,t-PA,D-dimer in treatment group were（35.36 ± 8.14） ng · mL^-1,（0.73 ± 0.30） AU · mL^-1,（1.97 ± 0.18） U · mL^-1,（0.42 ± 0.28）mg · L^-1.The TM,PAI,t-PA,D-dimer in control group were（39.50 ± 10.25） ng · mL^-1,（0.85 ± 0.26）AU · mL^-1,（1.35 ± 0.14） U · mL^-1,（0.43 ±0.24） mg · L^-1.There was significant difference compared with before treatment in two groups（P〈0.05）.There was significant difference between t-PA in treatment group and control group（P〈0.05）.The levels of VEGF after 3,7,14 d treatment were（320.24 ±45.63）,（436.33 ±35.84）,（398.31 ±46.60） ng · L^-1,had significant difference with those in control group,which were（370.41 ± 39.52）,（542.72 ± 68.00）,（352.72 ± 49.80） ng · L^-1（P〈0.05）.There was no adverse drug reaction during the treatment.Conclusion Xueshuantong injection and aspirin have significant effect in the treatment of acute recurrent cerebral infarction,can effectively improve the serum VEGF level.