人尿激肽原酶治疗进展性前、后循环脑梗死的疗效研究

Effects of Human Urinary Kallikrein in Treating Progressive Anterior and Posterior Circulation Cerebral Infarction

目的探讨在进展性前、后循环脑梗死中应用人尿激肽原酶的疗效。方法随机选取该院自2012年1月—2014年3月收治的120例进展性脑梗死患者,按照OSCP(英国牛津郡卒中研究)分型分为前循环脑梗死组68例和后循环脑梗死组52例。两组患者除给予脑梗死常规对症治疗外,加用人尿激肽原酶0.15 PNA单位,溶于100 m L生理盐水中,静脉泵入,1次/d,连续使用2周。记录两组患者治疗前后神经功能缺损评分(NIHSS)和日常生活活动能力量表(Barthel Index)评分。比较前循环脑梗死组和后循环脑梗死组的总有效率和显效率。结果治疗前,前循环脑梗死组和后循环脑梗死组NIHSS评分和Barthel Index评分相比较,差异无统计学意义(P>0.05);与治疗前相比较,前循环脑梗死组和后循环脑梗死组在治疗后神经功能缺损评分明显下降,日常生活活动能力量表评分明显上升,差异有统计学意义(P<0.01);治疗后,后循环脑梗死组神经功能缺损评分明显高于前循环脑梗死组,日常生活活动能力量表评分明显低于前循环脑梗死组,差异有统计学意义(P<0.01);后循环脑梗死组的总有效率和显效率均明显低于前循环脑梗死组,差异有统计学意义(P<0.05)。结论人尿激肽原酶治疗进展性前、后循环脑梗死均取得良好的临床效果,并且进展性前循环脑梗死更适合人尿激肽原酶治疗。

Objective To study the effects of human urinary kallikrein in treating progressive anterior and posterior circulation cerebral infarction. Methods 120 patients with progressive cerebral infarction admitted to our hospital from January 2012 to March2014 were chosen and divided into anterior circulation cerebral infarction group(68 cases) and posterior circulation cerebral infarction group(52 cases), which was based on Oxfordshire community stroke project. Besides both groups were given conventional treatments, human urinary kallikrein 0.15 PNA unit dissolved in 100 m L normal saline was pumped into vein once a day for two weeks. Before and after treatment, scores of the national institutes of health stroke scale(NIHSS) and Barthel Index were recorded.The total efficiency and the efficiency of the two groups were compared. Results Before treatment, the differences in NIHSS and Barthel Index scores were not statistical significant between two groups(P >0.05). After treatment, the NIHSS scores were significantly lower(P<0.01) and Barthel Index scores were significantly higher(P<0.01) in both groups compared to those before treatment. After treatment, the NIHSS scores of posterior circulation cerebral infarction group were significantly higher than those of anterior circulation cerebral infarction group(P<0.01), and Barthel Index scores were significantly lower than those of anterior circulation cerebral infarction group(P <0.01); the total efficiency and the efficiency of posterior circulation cerebral infarction group was significantly lower than that of the anterior circulation cerebral infarction group, respectively(P<0.05). Conclusion The effects of human urinary kallikrein in treating posterior circulation cerebral infarction were worse than in treating anterior circulation cerebral infarction. Human urinary kallikrein was more proper for treating anterior circulation cerebral infarction.