Batroxobin对狗心脏缺血/再灌注损伤中内皮素的影响

本工作研究Batroxobin对狗心脏I/R损伤过程中ET水平的影响。将狗左冠状动脉前降支结扎 30min ,恢复血流 90min ,造成I/R模型 ,于缺血前或缺血后 15min静注Batroxobin (1U/kg) ,测定血浆、心肌ET浓度以及血浆CK和LDH活性。结果表明 ,I/R组心肌组织及血浆ET水平明显升高 ,心肌组织明显损伤 ,Batroxobin能够显著降低再灌期血浆及心肌ET水平 ,降低CK及LDH活性 ,减轻心肌组织I/R损伤。

Batroxobin(DF-521)对动脉粥样硬化兔髂动脉球囊损伤后内膜增生的影响

目的 探讨Batroxobin(DF - 5 2 1)对动脉粥样硬化兔髂动脉球囊损伤后内膜增生的影响。方法 应用高胆固醇饮食饲养建立兔髂动脉粥样硬化模型。动物随机分为两组 ,治疗组 (n =10 ) :血管内膜球囊剥脱术后 5h静脉推注Batroxobin5 Bu,2 5 Bu隔日 1次静注 ,共 6次。对照组 (n =8) :术前术后不用药。术后 30d处死 ,分离血管 ,做病理形态学检查和细胞流式测定。结果 ①治疗组损伤血管内膜厚度小于对照组 ,而管腔横截面积大于对照组 (P均 <0 0 0 1)。②治疗组血管壁细胞增殖周期中增殖期细胞数明显低于对照组 (P均 <0 0 0 1)。结论 Batroxobin能抑制动脉粥样硬化兔髂动脉球囊损伤后血管平滑肌细胞 (VSMC)的增殖 。

东菱克栓酶(Batroxobin,DF-521)对渗出性中耳炎的治疗作用

为了解纤维蛋白溶解作用 (纤溶作用 )在中耳粘连发生中的意义 ,将 40例 (45耳 )渗出性中耳炎病人随机分为 3组 :地塞米松组 (G1)、东菱克栓酶 (Batroxobin ,DF 5 2 1) 1BU/ml组 (G2 )、东菱克栓酶 2BU/ml组(G3) ,经鼓膜穿刺冲洗 ,观察 3组疗效 ,最后有 31例 (33耳 )进行统计分析。根据 0 2 5～ 2kHz纯音气导听阈及自觉症状改善情况定性分析 ,3组治愈率分别为 41 7% (5 / 12 )、5 4 5 % (6 / 11)、70 % (7/ 10 ) ,G3比G1、G2高 (P <0 0 5 ) ,有效率分别为 5 0 % (6 / 12 )、81 8% (9/ 11)、80 % (8/ 10 ) ,G2、G3比G1高 (P <0 0 5 )。根据 0 2 5～ 2kHz纯音气导听阈定量分析 ,平均气导听阈在治疗前 3组无差异 (P >0 0 5 ) ,治疗后G3较G2、G1低 (P <0 0 5 ) ,治疗前后听力改善值G3、G2较G1大 (P <0 0 5 )。表明东菱克栓酶对渗出性中耳炎的疗效比地塞米松好 ,且G3组较G2组疗效更好。因此推测纤溶作用在中耳粘连形成中是重要因素 ,促纤溶药物可预防或减轻中耳粘连的形成。

Metabolic Changes in Rats with Photochemically Induced Cerebral Infarction and the Effects of Batroxobin:A Study by Magnetic Resonance Imaging,~1H-and ^(31)p-Magnetic Resonance Spectroscopy

Metabolic changes in rats with photochemically induced cerebral infarction and the effects of batroxobin were investigated 1, 3, 5 and 7 days after infarction by means of magnetic resonance imaging (MRI), 1H- and 31P-magnetic resonance spectroscopy (MRS). A region of T2 hyperintensity was observed in left temporal neocortex in infarction group and batroxobin group 1, 3, 5 and 7 days after infarction. The volume of the region gradually decreased from 1 day to 7 days after infarction. The ratio of NAA/Cho + Cr in the region of T2 hyperintensity in the infarction group was significantly lower than that in the corresponding region in the sham-operated group 3, 5 and 7 days after infarction respectively (P

GAP-43 Expression and Pathological Changes of Temporal Infarction in R.ats and Effects of Batroxobin

To study the changes of the expression of growth-associated protein-43 (GAP-43) and pathology in temporal infarction of rats photochemically induced and the effects of batroxobin. METHODS: Immunohistochemical technique and hematoxylin-eosin stain was used to show the changes of the expression of GAP-43 and pathology. RESULTS: In infarction group, GAP-43 expression was markedly increased on the infarction and surrounding tissues at 24 h cerebral infarction. The expression reached peak level at 72 h after cerebral infarction and was decreased at 7 d after cerebral infarction. However, in batroxobin-treated group, GAP-43 expression was increased and the pathological changes were much slight as compared with infarction group. CONCLUSION: The expression of GAP-43 increases in infarction of temporal neocortex and batroxobin promotes the expression of GAP-43 and ameliorates the pathological changes in infarction of temporal neocortex.

Effect of Batroxobin on Expression of Neural Cell Adhesion Molecule in Temporal Infarction Rats and Spatial Learning and Memory Disorder

The effect of Batroxobin expression of neural cell adhesion molecule (NCAM) in left temporal ischemic rats with spatial memory disorder was investigated by means of Morri's water maze and immunohistochemical methods. The results showed that the mean reaction time and distance of temporal ischemic rats for searching a goal were significantly longer than those of sham-operated rats and at the same time NCAM expression of left temporal ischemic region was significantly increased. However, the mean reaction time and distance of Batroxobin-treated rats were shorter and they used normal strategies more often and earlier than those of ischemic rats. The number of NCAM immune reactive cells of Batroxobin-treated rats was more than that of ischemic group. In conclusion, Batroxobin can improve spatial memory disorder of temporal ischemic rats and the regulation of the expression of NCAM is probably related to the neuroprotective mechanism.

Effect of Batroxobin on Neuronal Apoptosis During Focal Cerebral Ischemia and Reperfusion in Rats

We have found that Batroxobin plays a protective role in ischemic brain injury, which attracted us to investigate the effect of Batroxobin on apoptosis of neurons during cerebral ischemia and reperfusion. The apoptotic cells in ischemic rat brains at different reperfusion intervals were tested with method of TdT-mediated dUTP-DIG nick end labeling (TUNEL) and the effect of Batroxobin on the apoptosis of neurons was studied in left middle cerebral artery (LMCA) occlusion and reperfusion in rat models (n = 18). The results showed that few scattered apoptosis cells were observed in right cerebral hemispheres after LMCA occlusion and reperfusion, and that a lot of apoptosis cells were found in left ischemic cortex and caudoputamen at 12 h reperfusion, and they reached peak at 24 h-48 h reperfusion. However, in the rats pretreated with Batroxobin, the number of apoptosis cells in left cerebral cortex and caudoputamen reduced significantly and the neuronal damage was much milder at 24 h reperfusion than that of saline-treated rats. The results indicate that administration of Batroxobin may reduce the apoptosis of neurons induced by cerebral ischemia and reperfusion and afford significant cerebroprotection in the model of focal cerebral ischemia and reperfusion.

Effects of Batroxobin on Spatial Learning and Memory Disorder of Rats with Temporal Ischemia and the Expression of HSP32 and HSP70

The effect of Batroxobin on spatial memory disorder of left temporal ischemic rats and the expression of HSP32 and HSP70 were investigated with Morri`s water maze and immunohistochemistry methods. The results showed that the mean reaction time and distance of temporal ischemic rats in searching a goal were significantly longer than those of the sham-operated rats and at the same time HSP32 and HSP70 expression of left temporal ischemic region in rats was significantly increased as compared with the sham-operated rats. However, the mean reaction time and distance of the Batroxobin-treated rats were shorter and they used normal strategies more often and earlier than those of ischemic rats. The number of HSP32 and HSP70 immune reactive cells of Batroxobin-treated rats was also less than that of the ischemic group. In conclusion, Batroxobin can improve spatial memory disorder of temporal ischemic rats; and the down-regulation of the expression of HSP32 and HSP70 is probably related to the attenuation of ischemic injury.

Development and Validation of a Simoa Assay for Determination of Recombinant Batroxobin in Human Serum

Recombinant batroxobin(S3101)is a thrombin-like serine protease that binds to fibrinogen or is taken up by the reticuloendothelial system.A literature survey showed no adequate method that could determine sufficient concentrations to evaluate pharmacokinetic parameters for phase I clinical studies.Therefore,a sensitive method is urgently needed to support the clinical pharmacokinetic evaluation of S3101.In this study,a sensitive bioanalytical method was developed and validated,using a Quanterix single molecular array(Simoa)assay.Moreover,to thoroughly assess the platform,enzyme-linked immunosorbent assay and electrochemiluminescence assay were also developed,and their performance was compared with that of this novel technology platform.The assay was validated in compliance with the current guidelines.Measurements with the Simoa assay were precise and accurate,presenting a valid assay range from 6.55 to 4000 pg/mL.The intra-and inter-run accuracy and precision were within-19.3%to 15.3%and 5.5%to 17.0%,respectively.S3101 was stable in human serum for 280 days at-20℃and-70℃,for 2 h prior to pre-treatment and 24 h post pre-treatment at room temperature(22℃-28℃),respectively,and after five and two freeze-thaw cycles at-70℃and-20oC,respectively.The Simoa assay also demonstrated sufficient dilution linearity,assay sensitivity,and parallelism for quantifying S3101 in human serum.The Simoa assay is a sensitive and adequate method for evaluating the pharmacokinetic parameters of S3101 in human serum.

Treatment of primary hepatic carcinoma by transcatheter arterial perfusion of batroxobin combined with TACE:a preliminary clinical study

Objective:The aim of the study was to explore the therapeutic efficacy and safety of batroxobin in patients with primary hepatic carcinoma(PHC) and the advantages of transcatheter arterial perfusion of batroxobin combined with transcatheter arterial chemoembolization(TACE).Methods:Forty patients with PHC were randomized into experimental group(transcatheter arterial perfusion of batroxobin combined with TACE treatment,20 patients) and control group(TACE alone group,20 patients).The patients were followed up and the data were recorded,compared and analyzed.Results:(1) Compared with the control group,the FIB level in the experimental group was significantly decreased at the first month after treatment(P < 0.05).(2) The baseline of the tumor was shortened in both groups after the treatment.There was a significant difference between the two groups at different time intervals(P < 0.05).(3) After the treatment,there was a significant difference of progression-free survival(PFS) levels between the two groups(t =2.877,P < 0.05).(4) The incidence of metastasis were 5.0%(1/20) in both groups at 6 months after treatment,and that after one year was 10.0%(2/20) in the experimental group and 25.0%(5/20) in the control group.However,the difference was not significant(χ2 = 0.693,P > 0.05).Conclusion:Batroxobin can rapidly and effectively decrease the FIB level of the PHC cases.Therefore it may be used as an effective and safe adjuvant drug for the treatment of primary hepatic carcinomas.Transcatheter arterial perfusion of batroxobin combined with TACE therapy has advantages in comparison with TACE alone therapy.It could be taken as a new therapeutic regimen in the PHC treatment.

Effects of Ginaton combined with batroxobin on oxidative stress, hemodynamics and coagulation in SHL patients

Objective: To investigate the effects of ginaton combined with batroxobin on oxidative stress, hemodynamics and coagulation in patients with sudden hearing loss. Methods: According to random data table method, 100 cases of sudden hearing loss were randomly divided into the control group (n=50) and observation group (n=50), patients in the control group were given batroxobin treatment, the observation group received ginaton combined with batroxobin theraphy.The levels of oxidative stress, hemodynamics and coagulation were compared between the two groups before and after treatment. Results: The levels of WBV, HCT, PV, APTT, PT, TT, PF, SOD, LPO in the two groups before treatment were not statistically significant. After treatment, the levels of WBV, PV in the control group and observation group were respectively (5.33±0.62) mPa?s, (1.73±0.59) mPa?s and (4.07±0.55) mPa?s, (1.32±0.41) mPa?s, which were significantly lower than those before treatment, and after treatment in the observation group the levels of WBV, PV were significantly lower than the control group;After treatment, the levels of APTT, PT, TT, PF in the control group and observation group were respectively (43.75±6.15) s, (18.23±2.02) s, (15.38±2.51) s, (58.61±12.96) μg/L and (53.68±7.16) s, (24.67±4.35) s, (22.51±4.85) s, (41.47±8.63) μg/L, compared with those in the same group before treatment, the levels of APTT, PT and TT were significantly increased, PF level was significantly decreased, and in the observation group APTT, PT and TT levels were significantly higher and PF level was significantly lower than that in the control group. After treatment, the levels of SOD, LPO in the control group and observation group were respectively (101.78±10.53) nu/L, (5.91±0.95) mmol/L and (110.07±12.62) nu/L, (4.68±1.02) mmol/L compared with those in the same group before treatment, the level of SOD were significantly increased, the level of LPO level was significantly decreased, and in the observation group LPO level was significantly lower and SOD level was significantly higher than that in the control group. Conclusion Compared with the use of batroxobin alone, Ginaton combined with batroxobin can better reduce the stress response, improve hemodynamics and coagulation in patients with sudden hearing loss.

Neuroprotective role of Batroxobin in cardiopulmonary resuscitation rabbits

BACKGROUND： Batroxobin has been found to have protective effect on cerebral ischemia-reperfusion, and cardiopulmonary resuscitation （CPR） is the common cause of global brain ischemia-reperfusion. OBJECTIVE： To observe the effect of Batroxobin on the morphological results of cerebral cortex and hippocampus in rabbit models of CPR, and the changes of serum concentration of tumor necrosis factor alpha （TNF- α ） after CPR. DESIGN： A randomized controlled observation. SETTING： Laboratory of the Department of Bums, Changhai Hospital affiliated to the Second Military Medical University of Chinese PLA. MATERIALS： Thirty healthy New Zealand rabbits of 2.5 - 3.0 kg, either male or female, were used. Kits for TNF- α determination were provided by LIFEKEY BioMeditech Company （USA）. METHODS： The experiments were carried out in the laboratory of Department of Bums, Changhai Hospital from February 2001 to January 2002. The 32 rabbits were randomly divided into sham-operated group （n=8）, conventional resuscitation group （n=12） and Batroxobin-treated group （n=12）. The animals in the conventional resuscitation group and Batroxobin-treated group were anesthetized, then induced into modified Pittsburg＇s model of mechanical ventricular fibrillation. Sham-operated group was discharged on the chest wall, which did not cause ventricular fibrillation. Conventional resuscitation group and Batroxobin-treated group were exposed to 6 minutes of cardiac arrest induced by ventricular fibrillation, then the resuscitation began. A dosage of 0.3 Bu/kg of Batroxobin was administered to the rabbits in the Batroxobin-treated group at the beginning of resuscitation. Blood sample was collected at 4 and 12 hours after CPR to determine the concentration of TNF- α in serum. After the second blood collection, brain tissue was taken out immediately, and the forms of nerve cells in cerebral cortex and hippocampal CAl region were observed under light microscope. MAIN OUTCOME MEASURES： ① TNF- α concentration in serum at 4 and 12 hours after CPR; ② Forms of nerve cells in cerebral cortex and hippocampal CAI region at 12 hours after CPR. RESULTS： All the 31 New Zealand rabbits were involved in the analysis of results. ①TNF-α concentration in serum： At 4 hours after CPR, the TNF-α concentrations in serum in the conventional resuscitation group and Batroxobin-treated group [（5.947±2.366）, （5.122±2.521） ng/L] were significantly higher than that in the sham-operated group [（2.604±1.623） ng/L, P 〈 0.05]. At 12 hours after CPR, the TNF- α concentration in serum in the conventional resuscitation group was （7.770±3.121） ng/L, it was significantly higher than that at 4 hours （P 〈 0.05）, also significantly higher than that in the Batroxobin-treated group [（5.425±2.280） ng/L, P 〈 0.05]. ② Forms of nerve cells： In the sham-operated group, no abnormality was found in the hippocampal CAI region and cerebral cortex. In the conventional resuscitation group, the pyramidal cells in hippocampal CAI region were lined up in disorders, and edema, puff, vacuolization, nucleus concentration and anachromasis were also observed appeared; Edema of nerve cells, vacuole, pyknosis appeared in cerebral cortex; microthrombosis appeared in some blood capillaries. As compared with the conventional resuscitation group, cellular edema was relieved and pyknosis of nerve cells were obviously reduced, and no microthrombosis was found in hippocampal CAI region and cerebral cortex in the Batroxobin-treated group. CONCLUSION： Batroxobin have neuroprotective effect on CPR rabbits, and may inhibit the excessive increase of TNF- α concentration in serum.

Effect of Batroxobin on Expression of C-Jun in Left Temporal Ischemic Rats with Spatial Learning and Memory Disorder

The effect of Batroxobin on expression of c-Jun in left temporal ischemic rats with spatial memory disorder was investigated by means of Morri's water maze and immunohistochemistry methods. The results showed that the mean reaction time and distance of temporal ischemic rats for searching a goal were significantly longer than those of sham-operated rats, and at the same time c-Jun expression of left temporal ischemic region was significantly increased. However, the mean reaction time and distance of Batroxobin-treated rats were shorter and they used normal strategies more often and earlier than those of ischemic rats. The number of c-Jun immune reactive cells of Batroxobin-treated rats was also less than that of ischemic group. In conclusion, Batroxobin can improve spatial memory disorder in temporal ischemic rats, and the down-regulation of the expression of c-Jun is probably related to the neuroprotective mechanism.

Batroxobin Against Anoxic Damage of Rat Hippocampal Neurons in Culture:Morphological Changes and Hsp70 Expression

Batroxobin,the thrombin-like enzyme,is used for therapeutic defibrination. We have found that batroxobin has good therapeutic effect in ischemic reperfusion rats and clinical practices in vivo. But we have not studied the neuroprotective effect of batroxobin on anoxic hippocampal neurons in vitro. The purpose of this study was to obtain further information on the mechanism of the batroxobin-induced neuroprotection and examine the neuroprotective effect on neurons exposed to anoxia. The effect of batroxobin on anoxic damages in cultured hippocampal neurons of neonatal rats was investigated by using morphological changes and heat shock protein 70Kd (Hsp70) immunoreactive expression as indicators. The results indicate that batroxobin, besides its defibrination, may have a direct neuroprotective effect on anoxic damage of hippocampal neurons.

Batroxobin治疗脑血栓急性期15例疗效观察（摘要）

Ｂａｔｒｏｘｏｂｉｎ治疗脑血栓急性期１５例疗效观察（摘要）李永昌，余海，秦淑梅，冯大刚Ｂａｔｒｏｘｏｂｉｎ（商品名：东菱精制克栓酶）系南美蛇毒中采用生物技术提取的单成份溶血栓微循环治疗剂，能够专一性很强地分解血纤维蛋白原、诱发ｔ－ＰＡ释放、增强ｔ－Ｐ...

Effect of batroxobin combine with ginkgo-damole injection on hemodynamics, coagulation function, fibrinolytic function and related factors in patients with sudden deafness

Objective: To study the effects of combined use of Batroxobin and Ginkgo Leaf Extract and Dipyridamole Injection on hemodynamics, coagulation function, fibrinolytic function and related factors in patients with sudden deafness. Methods: A total of 94 patients with sudden deafness in our hospital were selected, and divided them into control group and observation group randomly, 47 cases in each group. All patients were given 10BU batroxobin injection intravenous drip after admission every other day;And the patients of observation group were given intravenous drip of 30ml ginkgo-damole injection, 1 time a day. The hemodynamics, coagulation function, fibrinolytic function and related factors were detected and compared between the two groups before and after treatment. Results: Before treatment, there was no statistical difference in hemodynamics, coagulation function, fibrinolytic function and related factors between the two groups;After treatment, the levels of WBV and PV in the control group was (5.21±0.58) mPa/s and (1.78±0.32) mPa/s, and the observation group was (4.13±0.47) mPa/s and (1.31±0.26) mPa/s, compared with the same group before treatment, there were statistical difference, and there was also statistical difference between the two groups;The levels of PT, APTT, TT and PF was (19.22±3.98) s, (43.57±9.88) s, (15.64±3.27) s and (58.22±10.58) μg/L, and the observation group was (23.97±4.82) s, (52.49±10.38) s, (20.59±4.15) s and (41.03±8.46) μg/L, compared with the same group before treatment, there were statistical difference, and there was also statistical difference between the two groups;The levels of Fib, D-dimer and FDP was (4.52±0.93) g/L, (6.53±1.88) mg/L and (8.17±2.34)μg/mL, and the observation group was (3.13±0.75 g/L, (9.75±2.14) mg/L, (13.52±2.58) μg/mL, compared with the same group before treatment, there were statistical difference, and there was also statistical difference between the two groups;The serum levels of ET, NO and SOD was (66.92±5.87) ρg/mL, (48.75±7.61) μmol/L, (95.01±12.38) NU/mL, and the observation group was (63.97±5.24) ρg/mL, (43.11±6.83) μmol/L, (104.79±13.15) NU/mL, compared with the same group before treatment, there were statistical difference, and there was also statistical difference between the two groups. Conclusion: The treatment of patients with sudden deafness using batroxobin combine with ginkgo-damole injection, can improve the hemodynamics, coagulation function, fibrinolytic function of patients, decrease the serum levels of ET and NO, improve the levels of SOD, the effect is curative, it's worthy of clinical application.

Protective effects of Batroxobin on spinal cord injury in rats

Expansion of the secondary injury following primary spinal cord injury is a major pathological event that increases destruction in the spinal cord, so measures to reduce secondary injury are needed. Our previous study demonstrated that, at the front of the expanding secondary injury in the spinal cord, there is an ischemic area in which many neurons can still be rescued. Therefore, enhancement of blood circulation in the cord may be helpful, and indeed, we found that a traditional Chinese medicine, shu-xue-tong, efficiently reduces the secondary injury. The aim of the present study was to investigate the effect of reducing fibrinogen with Batroxobin, a drug widely used clinically for ischemia, in rats with spinal cord contusion. We found that both 2 and 4 Batroxobin units （BU）/kg efficiently decreased the plasma fibrinogen, and 2 BU/kg significantly increased spinal blood flow, enhanced neuronal survival, mitigated astrocyte and microglia activation, and improved locomotor recovery. However, 4 BU/kg had no effect on the secondary spinal cord injury. These data suggest that Batroxobin has multiple beneficial effects on spinal cord injury, indicating a potential clinical application.

Batroxobin reduces intracellular calcium concentration and inhibits proliferation of vascular smooth muscle cells

Background Batroxobin (BX),a serine protease used in defibrinogenation and thrombolysis,also has an effect on c-fos gene and growth factor. This study attempted to determine the effects of BX on the proliferation of vascular smooth muscle cells (VSMCs) and calcium metabolism. Methods VSMCs were treated with BX at concentrations of 0.1,0.3,or 1.0 mmol/L and cell numbers were determined at 0,24,48,and 72 hours. Intracellular calcium concentration ([Ca 2+ ]_i) was measured using direct fluorescence methods. Results BX was found to suppress proliferation of VSMCs in a dose-dependent fashion with inhibition rates of 18% and 31% by 48 and 72 hours,respectively. In addition,BX decreases basal [Ca 2+ ]_i significantly. The basal level in untreated cells was 162.7±33.8 nmol/L,and decreased to 131.5±27.7 nmol/L,128.3±28.5 nmol/L,and 125.6±34.3 nmol/L with the three concentrations of BX,respectively. Noradrenaline (NE)-induced [Ca 2+ ]_i stimulation was also attenuated by BX (0.1 mmol/L BX,20%±8% inhibition; 0.3 mmol/L BX,54%±11% inhibition; 1.0 mmol/L BX,62%±15% inhibition). The ability of NE to stimulate [Ca 2+ ]_i was attenuated in cultures in Ca 2+ -free medium,as was the ability of BX to blunt NE-induced stimulation. Conclusion These findings demonstrate that BX can effectively inhibit proliferation of VSMCs,probably by blocking the release and uptake of Ca 2+ ,thus influencing [Ca 2+ ]_i.

下肢动脉钙化与下肢动脉硬化闭塞症患者血流动力学及外周血管支架联合巴曲酶治疗效果的关系

目的探讨下肢动脉钙化与下肢动脉硬化闭塞症(ASO)患者血流动力学及外周血管支架联合巴曲酶治疗效果的关系。方法筛选2022年2月至2024年2月于河北大学附属医院接受外周血管支架联合巴曲酶治疗的120例ASO患者作为观察组,另选取60例踝肱指数≥0.9的患者纳入对照组(非ASO患者)。根据治疗后6个月再狭窄是否>50%的情况将ASO患者分为预后良好组(62例,再狭窄程度≤50%)和预后不良组(58例,再狭窄程度>50%)。比较观察组与对照组的临床资料,分层回归分析血流动力学参数与股浅动脉钙化评分(SFACS)、膝下动脉钙化评分(BKACS)的关系;比较预后良好组与预后不良组的临床资料及治疗前后的踝肱指数、趾肱指数;Cox回归分析评估SFACS、BKACS与患者预后不良的关系;多元线性回归分析SFACS、BKACS与踝肱指数、趾肱指数的关系;限制性立方样条模型分析SFACS、BKACS与ASO患者预后不良风险的剂量-效应关系。结果观察组年龄、男性比例、吸烟史比例、胫后动脉收缩期血流速度峰值(Vs)、足背动脉Vs、SFACS、BKACS明显高于对照组,胫后动脉血管内径、足背动脉血管内径明显低于对照组(均P<0.05)。胫后动脉血管内径、足背动脉血管内径均对SFACS、BKACS产生显著的负向影响,胫后动脉Vs、足背动脉Vs均对SFACS、BKACS产生显著的正向影响(均P<0.05)。预后良好组和预后不良组C反应蛋白、白蛋白、纤维蛋白原、SFACS[2282(856,3259)分比4236(1547,6325)分]和BKACS[1024(526,1730)分比1951(1157,2968)分]比较差异均有统计学意义(均P<0.05)。预后良好组治疗后6个月和治疗后1、2年踝肱指数和趾肱指数均明显高于预后不良组(均P<0.05)。调整混杂因素前后,SFACS、BKACS均与患者预后不良风险呈正相关,与踝肱指数、趾肱指数呈负相关(均P<0.05)。ASO患者预后不良风险随SFACS、BKACS增加而增加(非线性P值分别为0.762和0.395)。结论下肢动脉钙化水平与ASO患者血流动力学有关,在一定程度上能够评估外周血管支架联合巴曲酶的治疗效果,因此在ASO的治疗过程中,可将其作为临床治疗的检查标志之一,用以及时优化治疗方案。

236例巴曲酶注射液治疗血管闭塞性疾病的警示医嘱用药分析

目的:回顾性分析巴曲酶注射液用于治疗血管闭塞性疾病的警示医嘱,为临床合理使用巴曲酶注射液提供参考。方法:基于PASS医嘱审核结果数据库,导出2020年9月至2023年6月河北省人民医院巴曲酶注射液所有警示级别的医嘱236例,进行统计分析。利用Excel软件辅助作图,计数资料采用频数及百分比描述,计量资料采用分段描述频数和百分比描述。结果:236例巴曲酶注射液治疗血管闭塞性疾病的警示医嘱中,男性患者(136例)、中老年患者(≥60岁,164例)居多;警示医嘱出现最多的科室是血管外科;警示级别中,橙灯问题占25.85%(61例),红灯问题占16.10%(38例),黑灯问题占58.05%(137例),黑灯警示医嘱均因为药物的相互作用。结论:男性、高龄是血管闭塞性疾病的高危因素;医嘱中存在禁忌证、超适应证、超频次及不符合维持剂量范围使用巴曲酶注射液的问题;同属纤维蛋白原溶解药以及巴曲酶注射液与阿司匹林的联合应用,并非绝对的禁忌,在控制好药物剂量、监测凝血-纤溶指标的前提下,上述药物联合应用可以进一步改善患者的临床结局。