注射用丹参多酚酸对缺血性脑卒中患者同型半胱氨酸、D-二聚体、高敏C-反应蛋白水平和血液流变参数的影响

Effect of Salvianolic Acid for Injection on Hcy, D-D, and hs-CRP level and hemorheological parameters in patients with ischemic stroke

目的观察注射用丹参多酚酸对缺血性脑卒中患者血浆同型半胱氨酸(Hcy)、血清D-二聚体、高敏C-反应蛋白(hs-CRP)水平和血液流变参数的影响,并监测不良反应发生情况。方法收集2016年3月—2017年8月许昌市中心医院的神经内科缺血性脑卒中住院病患,共118例。采用随机平行法将患者分为对照组、观察组,对照组采用常规治疗方法,包括尽早口服阿司匹林150～300 mg/d,并辅以血压调控、血糖控制以及并发症管理;观察组在对照组治疗基础上联合注射用丹参多酚酸0.13 g,用0.9%氯化钠注射液250 mL溶解后静脉滴注,每天1次;疗程均为14 d。观察临床疗效和不良反应发生情况,测评治疗前后血浆Hcy、血清D-二聚体、hs-CRP水平和血液流变参数。结果观察组治疗有效率为88.14%,与对照组的72.88%比较差异显著(P<0.05)。治疗后两组血浆Hcy、血清D-二聚体、hs-CRP水平均较治疗前均显著下降(P<0.05),且观察组各指标均显著低于对照组(P<0.05)。治疗后两组血浆黏度、全血高切黏度、血小板聚集率、全血低切黏度均较治疗前显著降低(P<0.05),且观察组各指标均显著低于对照组(P<0.05)。两组均未出现严重不良反应。结论注射用丹参多酚酸改善缺血性脑卒中患者Hcy、D-二聚体、hs-CRP水平以及血液流变参数,提高临床治疗有效率,并且表现出较高的安全性。

Objective To observe the effects of Salvianolic Acid for Injection on Hcy, D-dimer, hs-CRP levels and hemorheological parameters in patients with ischemic stroke, and to monitor the occurrence of adverse reactions. Methods From March 2016 to August 2017, a total of 118 patients were hospitalized from patients with neurological hemorrhagic stroke in Central Hospital of Xuchang City. Patients were divided into observation and control group by random parallel method. The patients in control group received routine treatment, including oral aspirin 150—300 mg/d as early as possible, supplemented by blood pressure control, blood sugar control and complication management. The patients in observation group was treated with salvianolic acid 100 mg for injection and 0.9% sodium chloride injection 250 mL for intravenous drip once a day on the basis of the control group. The course of treatment is 14 d. The clinical efficacy and adverse reactions were observed, and plasma Hcy, serum D-dimer, hs-CRP levels and blood rheology parameters were measured before and after treatment. Results After treatment, the levels of plasma Hcy, serum Ddimer and hs-CRP in two groups were significantly decreased compared with before treatment(P < 0.05), and the indexes in observation group were significantly lower than those in control group(P < 0.05). After treatment, the plasma viscosity, whole blood high-viscosity, platelet aggregation rate and whole blood low-cut viscosity of two groups were significantly lower compared with before treatment(P < 0.05), and the indexes of observation group were significantly lower than control group, showing statistically significant difference(P < 0.05). The effective rate of treatment in observation group was 88.14%, which was significantly different from control group(72.88%)(P < 0.05). No serious adverse reactions occurred in either group. Conclusion Salvianolic Acid for Injection has a certain effect on the improvement of ischemic stroke. In the clinical study, all patients evaluated improved blood rheological parameters, and improved serum Hcy, D-dimer, and hs-CRP. The clinical treatment efficiency of patients improved and showed higher security.