尤瑞克林联合基因重组链激酶对脑梗死患者的疗效

Effect of urinary kallidinogenase combined with recombinant streptokinase on cerebral infarction

目的观察尤瑞克林联合基因重组链激酶治疗脑梗死患者的疗效及其对患者血液流变学指标、纤维蛋白原受体(platelet activator combined-1,PAC-1)及CXC型趋化因子配体16(CXC chemokine ligand 16,CXCL16)的影响。方法选取脑梗死患者96例,按照随机数字表法均分为对照组和观察组。对照组患者给予基因重组链激酶+生理盐水治疗,作为空白对照,观察组在对照组治疗的基础上联合尤瑞克林。治疗2周后,比较2组患者的疗效和不良反应发生率。比较2组患者治疗前后美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分、日常生活活动能力(activities of daily living,ADL)评分、血液流变学、PAC-1和CXCL16因子水平。结果观察组和对照组有效率分别为95.83%、81.25%(χ^(2)=5.030,P=0.025)。治疗前,2组患者NIHSS评分、ADL评分、纤维蛋白原(fibrinogen,FIB)、全血还原黏度(whole blood reduced viscosity,RV)、血沉方程K值、红细胞电泳(erythrocyte electrophoresis,EEP)、红细胞压积(hematocrit,HCT)、血沉(erythrocyte sedimentation rate,ESR)、血浆黏度(plasma viscosity,PV)、全血黏度(whole blood viscosity,WBV)、PAC-1和CXCL16水平比较差异均无统计学意义(P>0.05)。治疗2周后,观察组PAC-1、CXCL16、FIB、RV、K值、EEP、HCT和ESR水平均低于对照组;观察组ADL评分高于对照组(t=8.021,P=0.000),NIHSS评分低于对照组(t=13.646,P=0.000)。2组患者不良反应发生率比较差异无统计学意义(χ^(2)=0.210,P=0.646)。结论尤瑞克林联合基因重组链激酶具有良好的临床疗效,且可以改善患者神经功能缺损症状、日常生活能力,改善患者血液流变学,抑制血小板聚集及降低机体炎症反应,改善细胞黏附作用,且安全性高。

Objective To observe the efficacy of urinary kallindinogenase(Eureklin)combined with recombinant streptokinase in the treatment of cerebral infarction and its effect on hemorheological indexes,platelet activator combined-1(PAC-1)and CXC chemokine ligand 16(CXCL16).Methods 96 patients with cerebral infarction were randomly divided into control group and observation group.The control group were treated with recombinant streptokinase saline as blank control,and the observation group were given Eureklin on the basis of the control group.Two weeks after treatment,the curative effect and adverse reaction rate of the 2 groups were compared.The National Institutes of Health Stroke Scale(NIHSS)scores,activities of daily living(ADL)scores,hemorheology,and PAC-1,CXCL16 factor levels were compared between the 2 groups before and after treatment.Results The effective rates of observation group and control group were 95.83%and 81.25%respectively(χ^(2)=5.030,P=0.025).There was no difference in NIHSS score,ADL score,fibrinogen(FIB),whole blood reduced viscosity(RV),K value,erythrocyte electrophoresis(EEP),hematocrit(HCT),erythrocyte sedimentation rate(ESR),plasma viscosity(PV),whole blood viscosity(WBV),PAC-1 and CXCL16 levels between the 2 groups before treatment(P>0.05).The PAC-1,CXCL16,FIB,RV,K value,EEP,HCT and ESR levels in observation group were lower than those in control group 2 weeks after treatment.The ADL score of the observation group was higher than that of the control group(t=8.021,P=0.000),and the NIHSS score was lower than that of the control group(t=13.646,P=0.000).The incidence of adverse reactions was different between the 2 groups(χ^(2)=0.210,P=0.646).Conclusion Eureklin combined with recombinant streptokinase has good clinical effect,and can improve the symptoms of neurological deficit and daily life ability,improve hemorheology,inhibit platelet aggregation,reduce inflammatory reaction,and improve cell adhesion with high safety.