降纤酶治疗急性脑梗死的对照研究

A matched control research of defibrase in treating acute cerebral infarction

目的 观察降纤酶对急性脑梗死的临床疗效及安全性 .方法 急性脑梗死患者 6 4例 ,随机分为治疗组 32例 ,用降纤酶首剂量 10 U,2～ 8d及 10 ,12和 14 d各用 5 U,溶入生理盐水 10 0 m L中静滴 .对照组 32例 ,用低分子右旋糖酐5 0 0 m L 加丹参注射液 4 0 m L,静滴 ,每日 4次 ,连用 14 d.按临床神经功能缺损程度评分标准于治疗前及治疗后 14 d进行疗效评定 .用 χ2 检验进行统计学处理 .结果 治疗组痊愈8例 (2 5 .0 % ) ,明显改善 15例 (46 .9% ) ,显效率 71.9% ,总有效率 90 .6 % ;对照组痊愈 4例 (12 . 5 % ) ,明显改善 8例(2 5 .0 % )显效率 37.5 % ,总有效率 6 8.8% ;两组总有效率和显效率差异显著 (P<0 .0 1) .治疗组在发病 12 h内及 12 h后用药的显效率分别为 91.7%和 5 5 .0 % ,差异显著 (P<0 .0 1) .治疗前后血栓指数、血小板聚集率、血液粘度和纤维蛋白原 ,均有显著性差异 (P<0 .0 1) ,血细胞比容无显著差异 (P>0 .0 5 ) .结论 早期应用降纤酶治疗急性脑梗死有显著疗效 .

AIM To observe the clinical effectiveness andsafety of defibrase in treating acute cerebral infarction. METHODS 64 patients with acute cerebral infarction were randomly divided into 2 groups: treatment group using defibrase 10 U initially, 5 U at 2-8 days and 10, 12, 14 d; and control group. The efficacy was evaluated before and 14 days after the treatment according to the score of clinical neural function impairment. The data was analyzed statistically by χ 2 test. RESULTS Firstly, in the treatment group 8 cases were cured (25.0%), 15 markedly improved (46.9%) while in the control group 4 cases were cured (12.5%), 8 markedly improved (25.0%). Both total effectiveness and obvious effectiveness between the two groups (90.6%), (71.9%) in treatment group, (68.8%), (37.5%) in control one, respectively) were all statistically significant ( P <0.01). Secondly there was a significant difference between obvious effectiveness 12 h within (91.7%) and 12 h post accidence (55.0%) in the treatment group. Lastly, in the treatment group a statistically significant difference also exists between thrombosis index, platelet agglutination rate, blood viscosity and fibrinogen level pre and post treatment ( P <0.01), except hematocrit ( P >0.05). CONCLUSION There was significant effectiveness when defibrase was applied early in treating acute cerebral infarction. Defibrase is significantly effective in treating acute cerebral infarction.