丹红注射液联合重组人组织纤溶酶原激活剂治疗急性脑梗死的疗效研究

Effect of Danhong injection combined with recombinant human tissue plasminogen activator on acute cerebralinfarction

目的观察丹红注射液联合重组人组织纤溶酶原激活剂(rt-PA)治疗急性脑梗死的临床疗效。方法选择68例急性脑梗死患者,随机分为试验组和对照组,每组34例患者。对照组患者给予rt-PA治疗方案,试验组患者在对照组的基础上加用丹红注射液进行治疗,连续治疗28 d,比较两组患者溶栓前后的美国国立卫生卒中量表(NIHSS)评分、两组患者溶栓前后内皮素(ET-1)及一氧化氮指标、脑血流动力变化及两种方案的不良反应发生情况。结果两组患者溶栓后NIHSS评分均有一定程度的降低,试验组患者溶栓后14 d和28 d的NIHSS评分均低于对照组(t分别=6.27、6.93,P均<0.05),试验组28 d的NIHSS评分也低于14 d(t=5.11,P<0.05)。试验组在溶栓后ET-1低于对照组,一氧化氮水平上升高于对照组(t分别=7.47、9.38,P均<0.05);试验组溶栓后的峰流速、平均流速均高于对照组溶栓后(t分别=5.62、6.98,P均<0.05);峰流速差值及平均流速差值均低于对照组溶栓后(t分别=6.67、7.34,P均<0.05)。两组不良反应率比较,差异无统计学意义(χ2=1.56,P>0.05)。结论丹红注射液联合重组人组织纤溶酶原激活剂可以一定程度减轻神经功能损伤症状,改善脑部血流动力学状态。

Objective To observe the clinical effect of Danhong injection combined with recombinant tissue plasminogen activator（rt-PA）on acute cerebral infarction. Methods Sixty-eight patients with acute cerebral infarction were randomized into the control group and experimental group with 34 patients in each. Patients in the control group were treated with rt-PA.Patients in the experimental group were treated with Danhong injection on the basis of the rt-PA for 28 days consecutively.The national institutes of health stroke scales before and after thrombolysis between the two groups were compared. The levels of endothelin-1（ET-1）,nitric oxide（NO）and cerebral blood flow were measured before and after thrombolysis in both groups. Results The NIHSS scores of both groups decreased to a certain extent after thrombolysis. The NIHSS scores of14 d and 28 d after thrombolysis in experimental group were significantly lower than those in control group（t= 6.27,6.93,P〈0.05）. The NIHSS score of 28 d after thrombolysis was also lower than that of 14 d in experimental group（t= 5.11,P〈0.05）.After the thrombolytic therapy,the ET-1 level of the experimental group was lower than that of the control group,while the level of nitric oxide was higher（t= 7.47,9.38,P〈0.05）. The peak flow velocity and average flow velocity of the experimental group were higher than those of the control group after thrombolysis（t=5.62,6.98,P〈0.05）,while the peak flow velocity and average flow velocity of the experimental group were lower than those of the control group after thrombolysis（t =6.67,7.34,P〈0.05）. The difference in adverse reactions between the two groups was not statistically significant（χ2=1.56,P〈0.05）.Conclusion Danhong injection combined with recombinant human tissue plasminogen activator can relief the symptoms of neurological injury to a certain extent and improve cerebral hemodynamics.