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Dynamic changes in fibrinogen levels of patients with acute cerebral infarction after taking defibrase 被引量:3
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作者 Yi Guo Ling Wang Bingshan Tang Fangming Li Qizhang Wang 《Neural Regeneration Research》 SCIE CAS CSCD 2008年第5期513-516,共4页
BACKGROUND: At present, as a therapeutic drug mainly for reducing fibrinogen (FIB) levels, the dynamic influence of defibrase on the FIB levels of patients with acute cerebral infarction has not been clearly ascert... BACKGROUND: At present, as a therapeutic drug mainly for reducing fibrinogen (FIB) levels, the dynamic influence of defibrase on the FIB levels of patients with acute cerebral infarction has not been clearly ascertained. OBJECTIVE: To observe the dynamic changes in FIB levels of patients with acute cerebral infarction at different time points after taking defibrase. DESIGN, TIME AND SETTING: Randomized controlled clinical trial. The study was conducted in the Department of Neurology, the Second Affiliated Hospital of Jinan University, from June to November 2006. PARTICIPANTS: Sixty patients with acute cerebral infarction, who had been treated by the Neurological Department of the Second Affiliated Hospital of Jinan University from June to November 2006, were selected, including 37 males and 23 females, aged 35-75 years. All cases met the diagnostic criteria formulated by the Fourth National Cerebrovascular Disease Conference within 12 hours of onset. All the patients were confirmed with definite hemiparesis and cerebral infarction without coma, and were randomly divided into two groups: a treatment group (n =40) and a control group (n =20). Patients' families had the right to be informed and agree with the treatment, which had permission from the Hospital Ethics Committee. METHODS: Patients in the control group were given routine treatment with 30 mL fleabane and 0.75 g cytidine diphosphate added to 500 mL saline solution once a day for 14 consecutive days. Patients in the treatment group were given routine treatment and Haiwang defibrase injection (purchased from Changchu Guoao Bio-Pharmaceutical Co. Ltd., Approval document number H10983237) within 12 hours of infarction. Defibrase doses of 15, 12.5 and 10 U were given over 2 hours according to the patients' pre-treatment plasma FIB levels of ≥ 4.50 g/L, 3.50 4.49 g/L and 1.00 3.49 g/L, respectively. Plasma FIB levels in the treatment group were measured before, and once every six hours for 48 hours after administration of defibrase. Later, measurements were taken once every 12 hours and FIB levels were kept in a range of 0.5-1.3 g/L for one week. When the FIB level increased to over 1.3 g/L, a 5 U dose of defibrase was given again over two hours, FIB levels of the control group were measured once before treatment and once after one week of treatment MAIN OUTCOME MEASURES: (1) Dynamic changes of FIB levels in the defibrase treatment group. (2) Comparison of dynamic changes of FIB levels in the treatment group and control group before and after treatment for one week. RESULTS: All 60 patients were included in the final analysis. The treatment group's FIB levels quickly decreased to 0.5-1.3 g/L within 12 hours of taking the first dose of defibrase and reached a minimum in 24 hours. Later, they began to rise slowly into the therapeutic range (0.5-1.3 g/L) in 48 hours. The FIB levels of the treatment group increased slowly to over 1.3 g/L in 60 hours after the first dose of defibrase and then quickly decreased to the therapeutic range after the second dose of 5 U defibrase with a minimum level higher than after the first dose, and higher again after the third dose. After treatment, patients' FIB levels could be kept in the therapeutic range for about one week. The FIB levels in patients in the treatment group were significantly lower after taking defibrase for one week in comparison with the levels before treatment (P 〈 0.01). There was no difference in the control group between the levels pre-treatment and one week after treatment (P 〉 0.05). CONCLUSIONS: FIB levels in patients with acute cerebral infarction quickly decrease after taking the first dose of defibrase and reach a minimum in 24 hours. Later, they begin to rise slowly into the therapeutic range (0.5-1.3 g/L) in 48 hours. The FIB levels increase slowly to over 1.3 g/L in 60 hours. The effect of defibrase is weaker when the same dose of defibrase is used in patients repeatedly. 展开更多
关键词 cerebral infarction fibrinogen defibrase
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Monitoring the changes in plasm C-reactive protein,fibrinogen and blood white cell in patients with primary hypertension combined with acute cerebral infarction
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作者 Yuanfei Deng Juan Hang Yane Chen 《Neural Regeneration Research》 SCIE CAS CSCD 2006年第4期382-384,共3页
BACKGROUND: Inflammatory reaction and the increased level of its accompanying active protein play an important role in the occurrence and development of cerebral infarction. C-reactive protein, fibrinogen and white b... BACKGROUND: Inflammatory reaction and the increased level of its accompanying active protein play an important role in the occurrence and development of cerebral infarction. C-reactive protein, fibrinogen and white blood cell, as the monitoring index of inflammatory reaction, are very important in the occurrence and development of acute cerebral infarction. OBJECTIVE: To make a comparison between patients with primary hypertension accompanied with acute cerebral infarction and with simple primary hypertension by observing the changes in plasma C-reactive protein and fibrinogen levels as well as white blood cell and differential counts and analyzing their significances. DESIGN : Controlled observation SETTING : Ward Building for VIP, Shenzhen Hospital, Peking University. PARTICIPANTS: Totally 133 patients with primary hypertension were selected from Ward Building for VIP, Shenzhen Hospital, Peking University during September 2003 to September 2005, The diagnostic criteria were based on the hypertension diagnosis criteria formulated by the 7^th World Health Organization-International Society of Hypertension Guidelines (WHO-ISH) in 1998. The informed consents were obtained from all the participants. The involved patients were assigned into two groups: primary hypertension group, in which, there were 65 patients with primary hypertension ( degree 2), including 42 males and 23 females, with mean age of (61 ±14)years and mean blood pressure of (162.7±6.8)/(94.2±8.4) mm Hg (1 mm Hg =0.133 kPa), and primary hypertension combined with cerebral infarction group, in which, there were 68 patients with primary hypertension combined with cerebral infarction ( meeting the diagnostic criteria formulated in the 4^th National Cerebrovascular Diseases Meeting in 1995 and diagnosed by skull CT or MRI to exclude the patients with lacunar infarction), including 42 males and 26 females, with mean age of (56±15) years and mean blood pressure of (176.4±9.2)/(96.3±9.7) mm Hg. METHODS: Plasm C-reactive protein and fibrinogen levels, and white blood cell and differential counts of patients in the two groups were examined 24 hours after stroke. The above indexes were re-examined in the primary hypertension combined with cerebral infarction group 72 hours after stroke. White blood cell and differential counts were performed with laser method (East Asia FE-95001 RAM-1, Japan). The level of C-reactive protein was measured with turbidimetry (BNII Automatic Systems For Analysis, USA). The level of fibrinogen was measured with algorithm method when prothrombin time was normal and with Clauss method when prothrombin time was abnormal (ACL Automatic Coagulation Analyzer, USA). MAIN OUTCOME MEASURES: The plasm C-reactive protein and flbrinogen levels, and white blood cell and differential counts 24 hours after stroke in two groups and 72 hours after stroke in primary hypertension combined with cerebral infarction group. RESULTS: All the 133 involved patients participated in the result analysis. The plasm C-reactive protein and fibrinogen levels, and white blood cell and neutrophil counts in patients with primary hypertension were all within the normal range. The plasm C-reactive protein and fibrinogen levels, and white blood cell and neu- trophil counts in patients with primary hypertension combined with cerebral infarction were significantly higher than those in patients with primary hypertension 24 hours after stroke and 72 hours after stroke respectively[24 hours after stroke:(32.12±11.76) mg/L vs. (5.02±3.21 ) mg/L;(4.64±0.75) g/L vs. (3.12±0.49) g/L; (9.32±81)×10^9 L^- 1 vs. (5.78±1.32)×10^9L^- 1 (7.85±2.38)×10^9 L^- 1 vs.(3.49±1.28)×10^9 L^-1,t =7.094, 5.759,4.106,5.491, respectively,all P〈 0.01; 72 hours after stroke: (47.62±18.43) mg/L vs. (32.12±11.76) mg/L; (5.08±0.82) g/L vs. (4.64±0.75) g/L, t =2.864,2.220, respectively, both P 〈 0.05]. CONCLUSION: The increase in fibrinogen level and white blood cell count are the important index in monitoring primary hypertension combined with acute cerebral infarction. The increase in plasm C-reactive protein and fibrinogen levels 72 hours after stroke indicates that plasma C-reactive protein and fibrinogen are very important in the development of disease. 展开更多
关键词 Monitoring the changes in plasm C-reactive protein fibrinogen and blood white cell in patients with primary hypertension combined with acute cerebral infarction CELL
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REASSESSMENT OF DEFIBRASE IN TREATMENT OF ACUTE CEREBRA LINFARCTION :A MULTICENTER ,RANDOMIZED ,DOUBLE-BLIND ,PLACEBO-CONTROLLED TRIAL 被引量:25
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作者 The Cooperative Group for Reassessment of Defibrase,China 《Chinese Medical Sciences Journal》 CAS CSCD 2005年第3期151-158,共8页
Objoctive To evaluate the efficacy and safety of defibrase in patients with acute cerebral infarction by a large sample, multicenter, randomized, double-blind, placebo-controlled clinical trial. Mothods Patients with... Objoctive To evaluate the efficacy and safety of defibrase in patients with acute cerebral infarction by a large sample, multicenter, randomized, double-blind, placebo-controlled clinical trial. Mothods Patients with acute cerebral infarction within 12 hours of stroke onset were randomly assigned to receive either an initial intravenous infusion of defibrase 15 U plus normal saline 250 mL or 250 mL of normal saline only. Subsequent infusions of defibrase 5 U or placebo (normal saline) were given on the 3rd, 5th, 7th, and 9th day, respectively. Both groups received standard care of acute cerebral infarction. The primary efficacy outcome was functional status (Barthel Index) at 3 months after treatment. Safety outcome were bleeding events and mortality rate. Secondary outcome included Chinese Stroke Scale (CSS) score at 14 days and recurrence rate of stroke at 1 year. A total of 1053 patients were enrolled at 46 centers from September 2001 to July 2003, and 527 patients were randomly assigned to receive defibrase and 526 to receive placebo. A similar proportion of patients in both groups completed a full course of treatment. There was a significantly greater proportion of favorable functional status (Barthel Index 1≥95) in defibrase group than in placebo group at 3 months (52.2% vs. 42.8%, P 〈 0.01), and the proportion of dependent functional status (Barthel Index ≤60) was a little lower in defibrase group compared with placebo group (27.7% vs. 32.4%). These differences were more obvious among patients who were treated within 6 hours of stroke onset. Patients in defibrase group had better improvement with respect to CSS score than those in placebo group at 14 days (P 〈 0.05). Recurrence rate of stroke at 1 year was lower in the defibrase group compared with placebo group (6.2% vs. 10.1%, P = 0.053). Patients in defibrase group had higher risk of extracranial bleeding events (4.7% vs. 1.5%, P 〈 0.01 ) and a tendency of higher risk of symptomatic intracranial hemorrhage. The hemorrhage incidence was higher in patients with fibrinogen level 〈 130 mg/dL than ≥ 130 mg/dL (10.6% vs. 3.8%, P 〈 0.05). Mortality rate at 3 months were slightly higher in defibrase group than placebo group (5.9% vs. 4.2%). Conclusions The defibrase is effective to improve neurological function and function of daily living for patients with acute cerebral infarction within 12 hours of symptom onset. The efficacy was even better for acute cerebral infarction within 6 hours of onset. The increased risks of intra- and extracranial hemorrhage during defibrase administration were related to the plasma fibrinogen level. 展开更多
关键词 defibrase acute cerebral infarction fibrinogen
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Clinical Studies on Treatment of Acute Cerebral Infarction with Xueshuantong(血栓通)Injection 被引量:2
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作者 杜金行 任在方 +1 位作者 史载祥 黄力 《Chinese Journal of Integrated Traditional and Western Medicine》 2003年第1期21-24,共4页
Objective: To observe the effect of Xueshuantong injection (XST,血栓通注射液) with its ingredient as Notoginseng saponin, on acute cerebral infarction (ACI) and on blood coagulation and fibri-nolysis, so as to compreh... Objective: To observe the effect of Xueshuantong injection (XST,血栓通注射液) with its ingredient as Notoginseng saponin, on acute cerebral infarction (ACI) and on blood coagulation and fibri-nolysis, so as to comprehensively analyse the mechanism of XST. Methods: Fifty ACI patients were randomly divided into 2 groups, and XST group (30 patients) was treated with XST, and the control group (20 patients) given low molecular dextrose, as well as low molecular heparin calcium. The course of treatment for both groups was 15 days. The changes of effective rate, score of neurologic impairment, tissue-type plasminogen activator (tPA), inhibitor of plasminogen activator (PAI), D-D dimmer, antithrombin-III (AT-III), and fibrinogen (Fbg) were all observed. Results: The total effective rate of XST group was 73.33%, that of the control group 65. 00%. After the therapy, plasma level of tPA, ratio of tPA/PAI, and AT-III content were increased obviously, while the plasma level of PAI and D-D dimmer were decreased significantly (all P<0.01) . But there was only insignificant difference between the 2 groups (P> 0.05).Conclusion: XST injection could be effective to ACI, the mechanism of which is probably related to improving the balance between plasminogen activator and its inhibitory factor, increasing the activity of fi-brinolysin, inactivating thrombin, inhibiting platelet aggregation induced by thrombin, and decreasing blood coagulation. 展开更多
关键词 XUESHUANTONG acute cerebral infarction tissue type plasminogen plasminogen inhibitor D-D dimmer antithrombin-III fibrinogen
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EFFECT ON BLOOD CLOTTING AND FIBRINOLYSIS WITH ELECTRO-ACUPUNCTURE TREATMENTS AT "BAIHUI" AND "SHUIGU" ACUPOINTS FOR CEREBRAL INFARCTION IN RATS 被引量:1
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作者 王述菊 孙国杰 +2 位作者 吴绪平 黄伟 丁昀 《World Journal of Acupuncture-Moxibustion》 2008年第2期23-27,共5页
Objective To investigate the effective mechanism of the treatments with electroacupuncture (EA) at "BǎiHuì" (GV20) and "ShuǐGōu" acupoints for cerebral infarction. Methods Forty rats were randomly divi... Objective To investigate the effective mechanism of the treatments with electroacupuncture (EA) at "BǎiHuì" (GV20) and "ShuǐGōu" acupoints for cerebral infarction. Methods Forty rats were randomly divided into four groups as normal group (n = 10), sham-operation group (n = 10), model group (n = 10), EA group (n = 10). The acute cerebral infarction model in rats was developed by blocking the middle cerebral artery with an intraluminal thread. The contents of t-PA,PAI-1 ,D-D and Fib were estimated in each group. Results The contents of t-PA, PAI-1, D-D and Fib increased significantly (P〈0.01) in the model group as compared to the normal and sham-operation group. The contents of t-PA, PAI-1, D-D and Fib decreased significantly (P〈0.05-0.01) in the EA group as compared to the normal group. Conclusion The balance function of blood clotting and fibrinolysis were good and the cerebral abnormal blood was improved in EA group. 展开更多
关键词 acute cerebral infarction electroacupuncture t-PA PAI-1 D-dimer fibrinogen
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Lp-PLA2、hs-CRP和FIB联合检测在急性脑梗死诊断中的应用 被引量:3
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作者 孟凤琴 曹军 +2 位作者 石亚志 李战永 于奇 《标记免疫分析与临床》 CAS 2024年第2期287-291,共5页
目的探讨血浆脂蛋白相关磷脂酶A2(Lp-PLA2)、超敏C反应蛋白(hs-CRP)和纤维蛋白原(FIB)联合检测在急性脑梗死诊断中的临床价值。方法收集我院240例急性脑梗死的住院患者作为研究对象(脑梗组),以100例门诊体检健康人员为对照组,比较两组... 目的探讨血浆脂蛋白相关磷脂酶A2(Lp-PLA2)、超敏C反应蛋白(hs-CRP)和纤维蛋白原(FIB)联合检测在急性脑梗死诊断中的临床价值。方法收集我院240例急性脑梗死的住院患者作为研究对象(脑梗组),以100例门诊体检健康人员为对照组,比较两组人群的一般临床数据及检验结果,记录患者入院时的NIHSS评分。分析急性脑梗死患者血浆Lp-PLA2、hs-CRP和FIB水平与其神经功能缺损程度的关系,进行多因素Logistic回归分析确定急性脑梗死的危险因素,利用ROC曲线评估患者血浆Lp-PLA2、hs-CRP和FIB水平对急性脑梗死的诊断价值。结果重度脑梗死患者的Lp-PLA2、hs-CRP和FIB水平均高于轻度及中度脑梗死患者(P<0.05);与对照组比较,脑梗组患者的血浆Lp-PLA2、hs-CRP和FIB水平均显著升高,差异均具有统计学意义(P<0.05)。血浆Lp-PLA2、hs-CRP和FIB水平与急性脑梗死发病风险显著相关(P<0.05)。Lp-PLA2、hs-CRP和FIB 3个指标中,Lp-PLA2的ROC曲线下面积最大,诊断价值最高;Lp-PLA2、hs-CRP和FIB联合检测能显著提高急性脑梗死的诊断效率。结论联合检测Lp-PLA2、hs-CRP和FIB对判断ACI患者神经功能缺损程度具有较高价值。 展开更多
关键词 急性脑梗死 脂蛋白相关磷脂酶A2 超敏C反应蛋白 纤维蛋白原
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脑利钠肽、超敏C反应蛋白、纤维蛋白原与急性脑梗死患者NIHSS评分关系及支架介入成形术预后预测效能探究
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作者 黄家建 黄渊智 农金尧 《脑与神经疾病杂志》 CAS 2024年第12期740-745,共6页
目的分析脑利钠肽(BNP)、超敏C反应蛋白(hs-CRP)、纤维蛋白原(FIB)与急性脑梗死(ACI)患者神经功能缺损评分(NIHSS)关系及对支架介入成形术预后预测效能。方法选择2020年3月至2022年3月于广西钦州市第二人民医院神经内科接受支架介入成... 目的分析脑利钠肽(BNP)、超敏C反应蛋白(hs-CRP)、纤维蛋白原(FIB)与急性脑梗死(ACI)患者神经功能缺损评分(NIHSS)关系及对支架介入成形术预后预测效能。方法选择2020年3月至2022年3月于广西钦州市第二人民医院神经内科接受支架介入成形术的120例ACI患者作为研究对象,检测手术前后BNP、hs-CRP、FIB水平及NIHSS评分。出院后进行3个月的随访,根据改良Rankin量表评分分为预后良好组(Rankin评分≤2分)与预后不良组(Rankin评分≥3分),对比两组术前基础资料与BNP、hs-CRP、FIB水平及NIHSS评分,建立Logistic回归模型分析支架介入成形术预后的影响因素;经Pearson相关性检验BNP、hs-CRP、FIB水平与NIHSS评分的关系;绘制ROC曲线分析BNP、hs-CRP、FIB水平对预后的预测价值。结果手术后ACI患者的血清BNP、hs-CRP、FIB水平及NIHSS评分均比手术前降低(P<0.05);术后随访1个月的改良Rankin量表评分显示,120例患者预后良好的有82例(68.33%),预后不良的有38例(31.67%);预后良好组、预后不良组性别、年龄、病程、饮酒史、吸烟史、高血压病史、冠心病史、糖尿病史相比,差异无统计学意义(~均P>0.05);预后不良组BNP、hs-CRP、FIB水平及NIHSS评分均较预后良好组高(~均P<0.05);二元Logistic回归分析结果显示,BNP、hs-CRP、FIB水平、NIHSS评分均是ACI患者支架介入成形术预后的危险因素(OR>1,P<0.05);绘制ROC曲线发现,BNP、hs-CRP、FIB水平及联合预测支架介入成形术预后的AUC为0.807(95%CI:0.730~0.884)、0.797(95%CI:0.701~0.892)、0.821(95%CI:0.746~0.896)、0.887(95%CI:0.827~0.948)。结论BNP、hs-CRP、FIB水平与ACI患者神经缺损程度呈正相关,且通过联合检测可提高支架介入成形术预后的预测效能,临床应监测上述指标以制定相关方案改善患者预后。 展开更多
关键词 急性脑梗死 支架介入成形术 脑利钠肽 超敏C反应蛋白 纤维蛋白原 NIHSS评分 预后
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超时间窗机械取栓联合动脉溶栓治疗急性脑梗死的疗效观察
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作者 卢鸿 代津津 韩桃 《当代医学》 2024年第6期56-59,共4页
目的探讨超时间窗机械取栓联合动脉溶栓治疗急性脑梗死的疗效。方法选取2017年10月至2019年6月荆州市第三人民医院需行超时间窗溶栓治疗的90例急性脑梗死患者作为研究对象,按照治疗方式不同分为研究组与对照组,各45例。对照组给予动脉... 目的探讨超时间窗机械取栓联合动脉溶栓治疗急性脑梗死的疗效。方法选取2017年10月至2019年6月荆州市第三人民医院需行超时间窗溶栓治疗的90例急性脑梗死患者作为研究对象,按照治疗方式不同分为研究组与对照组,各45例。对照组给予动脉溶栓治疗,研究组在对照组基础上给予机械取栓治疗。比较两组临床疗效,凝血指标[凝血酶原时间(PT)、纤维蛋白原(Fg)、凝血酶时间(TT)],血清超敏C反应蛋白(hs-CRP)、氧化型低密度脂蛋白(Ox-LDL)、同型半胱氨酸(Hcy)水平,美国国立卫生研究院卒中量表(NIHSS)评分、欧洲卒中量表(ESS)评分及预后情况。结果研究组治疗总有效率为93.33%,高于对照组的73.33%,差异有统计学意义(P<0.05)。治疗后,研究组PT长于对照组,TT短于对照组,Fg、hs-CRP、Ox-LDL、Hcy水平均低于对照组,差异有统计学意义(P<0.05);治疗后,研究组ESS评分高于对照组,NIHSS评分低于对照组,差异有统计学意义(P<0.05)。研究组血管再通率、≤30%残余狭窄率均高于对照组,颅内出血率低于对照组,差异有统计学意义(P<0.05)。结论超时间窗机械取栓联合动脉溶栓治疗急性脑梗死疗效显著,可有效调节凝血指标,降低炎症反应及脂蛋白水平,提高血管再通率,减轻患者病情严重程度,改善预后。 展开更多
关键词 超时间窗机械取栓 动脉溶栓 急性脑梗死 血管再通率 凝血功能 纤维蛋白原
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BNP、Hcy、D-D以及FIB水平在急性脑梗死诊断中的应用价值
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作者 华方方 汪双信 张忠诚 《系统医学》 2024年第21期25-28,共4页
目的 分析脑钠肽(brain natriuretic peptide, BNP)、同型半胱氨酸(homocysteine, Hcy)、D-二聚体(Ddimer, D-D)、纤维蛋白原(fibrinogen, FIB)水平对急性脑梗死(acute cerebral infarction, ACI)的诊断效能。方法非随机选取2022年1月—... 目的 分析脑钠肽(brain natriuretic peptide, BNP)、同型半胱氨酸(homocysteine, Hcy)、D-二聚体(Ddimer, D-D)、纤维蛋白原(fibrinogen, FIB)水平对急性脑梗死(acute cerebral infarction, ACI)的诊断效能。方法非随机选取2022年1月—2023年6月南京市溧水区人民医院收治的394例ACI患者作为观察组,选取同期102名健康体检人员作为对照组,根据ACI患者严重程度分为轻度、中度和重度组。对比各组的BNP、Hcy、D-D、FIB水平,并分析其对ACI的诊断效能。结果 对照组BNP、Hcy、FIB、D-D水平均低于观察组,差异有统计学意义(P均<0.05)。轻度组BNP、Hcy、FIB、D-D水平均低于中度、重度组,且中度组各项指标水平均低于重度组,差异有统计学意义(P均<0.05)。BNP、Hcy、FIB、D-D单一诊断ACI的AUC分别为0.907、0.792、0.704、0.803,低于联合诊断的AUC(0.975)。结论 在ACI的临床诊断中,BNP、Hcy、FIB、D-D四项指标均具有一定的诊断效能,但联合诊断价值较高。 展开更多
关键词 急性脑梗死 脑钠肽 同型半胱氨酸 D-二聚体 纤维蛋白原
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N端脑钠肽、同型半胱氨酸、D-二聚体、纤维蛋白原水平与急性脑梗死疾病严重程度的相关性分析
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作者 倪文伟 《系统医学》 2024年第6期1-4,共4页
目的探究N端脑钠肽、同型半胱氨酸、纤维蛋白原、D-二聚体与急性脑梗死严重程度的相关性。方法选取2021年2月—2023年8月南通市瑞慈医院收治的118例急性脑梗死患者为研究对象,患者入院后使用美国国立卫生院卒中量表(National National H... 目的探究N端脑钠肽、同型半胱氨酸、纤维蛋白原、D-二聚体与急性脑梗死严重程度的相关性。方法选取2021年2月—2023年8月南通市瑞慈医院收治的118例急性脑梗死患者为研究对象,患者入院后使用美国国立卫生院卒中量表(National National Health Stroke Scale,NIHSS)对患者疾病严重程度进行评估,根据NIHSS评分将患者分成轻度组(n=35)、中度组(n=46)和重度组(n=37),对比3组患者N端脑钠肽、血清同型半胱氨酸、纤维蛋白原、D-二聚体水平,分析上述指标与急性脑梗死疾病严重程度的相关性。结果3组同型半胱氨酸水平对比,差异无统计学意义(P>0.05);轻度组N端脑钠肽、纤维蛋白原、D-二聚体水平低于中度组和重度组,差异有统计学意义(P均<0.05)。N端脑钠肽、D-二聚体、纤维蛋白原水平与急性脑梗死严重程度呈正相关(r=0.95、0.30、0.78,P均<0.05)。结论N端脑钠肽、纤维蛋白原、D-二聚体与急性脑梗死的严重程度呈正相关,可以作为疾病严重程度的反馈指标。 展开更多
关键词 N端脑钠肽 同型半胱氨酸 D-二聚体 纤维蛋白原 急性脑梗死 严重程度 相关性
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基于血浆纤维蛋白原水平的降纤酶方案治疗急性脑梗死的临床研究 被引量:10
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作者 蔡晓斌 朱治山 +2 位作者 张明之 郭瑾 王辉兰 《南方医科大学学报》 CAS CSCD 北大核心 2009年第10期2124-2127,共4页
目的根据血浆纤维蛋白原(FIB)水平给予不同剂量降纤酶治疗,探讨降纤酶个体化剂量治疗急性脑梗死(ACI)的疗效。方法60例急性脑梗死(发病72h内)患者随机分为2组,降纤酶组30例,对照组30例。降纤酶治疗组根据治疗前血浆FIB水平>4g/L,2~4... 目的根据血浆纤维蛋白原(FIB)水平给予不同剂量降纤酶治疗,探讨降纤酶个体化剂量治疗急性脑梗死(ACI)的疗效。方法60例急性脑梗死(发病72h内)患者随机分为2组,降纤酶组30例,对照组30例。降纤酶治疗组根据治疗前血浆FIB水平>4g/L,2~4g/L,1.3~2g/L分别给予首剂降纤酶15U,10U,5U,给药后每12h监测一次血浆FIB水平,当血浆FIB水平>1.3g/L时再次给予降纤酶5U,维持患者血浆FIB水平在0.7~1.3g/L之间达7d时间,检测治疗前及治疗7d后血浆凝血酶原时间(PT)、血浆活化部分凝血激酶时间(APTT)、血浆纤维蛋白原(Fg)水平,并在治疗14d后进行神经功能缺损程度评分(CSS)和3个月后日常生活活动(ADL)量表评分,评价临床疗效。结果(1)治疗7d降纤酶组血浆PT、APTT延长,Fg下降,与治疗前及对照组比较,差异均有显著性。(2)治疗14d降纤酶组神经功能缺损程度评分改善,与治疗前及对照组比较,差异均有显著性。(3)临床疗效降纤酶组总有效率80%,对照组总有效率50%,两组比较差异有显著性。(4)治疗后3个月日常生活活动量表评分,两组比较差异无显著性,但(独立+轻度依赖)比例降纤酶组为93.3%,对照组为70.0%,两组比较差异有显著性。(5)治疗期间降纤酶组无颅内外出血,随访3个月无死亡病例发生。结论基于血浆纤维蛋白原水平,应用降纤酶治疗急性脑梗死能快速平稳降低患者血浆纤维蛋白原水平,减少神经功能缺损,提高生活质量。个体化降纤酶治疗安全有效。 展开更多
关键词 降纤酶 急性脑梗死 治疗 个体化
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国产降纤酶治疗急性脑梗死临床研究 被引量:4
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作者 管小亭 龙洁 +7 位作者 董可辉 柴滨 王素香 张宁 牛松涛 李伟 张在强 曲辉 《中国全科医学》 CAS CSCD 2001年第12期948-950,共3页
目的 观察国产降纤酶治疗急性脑梗死的临床疗效和对血浆纤维蛋白原 (FIB)、凝血酶原时间(PT)、D -二聚体 (D -D)等指标的影响。并注意有无出血合并症及其他不良反应的存在。方法 采用随机双盲分组 ,共观察急性脑梗死患者 90例 ,其中... 目的 观察国产降纤酶治疗急性脑梗死的临床疗效和对血浆纤维蛋白原 (FIB)、凝血酶原时间(PT)、D -二聚体 (D -D)等指标的影响。并注意有无出血合并症及其他不良反应的存在。方法 采用随机双盲分组 ,共观察急性脑梗死患者 90例 ,其中治疗组 4 9例 ,对照组 4 1例。治疗组于发病第 1、 3、 5天分别给予降纤酶 10U、 5U、 5U静滴 ,对照组给予安慰剂治疗 ,于治疗前后进行临床疗效评定及血浆FIB、PT、D -D等指标检查。结果 临床神经功能缺损程度评分及Barthel指数 :治疗组及对照组治疗后 ( 14天及 3个月 )均有明显下降(P <0 0 0 1) ,但两组之间比较差异无显著性 (P >0 0 5 )。血浆FIB :治疗组治疗后下降明显 (P <0 0 0 1) ,而对照组下降不明显 (P >0 0 5 )。PT :治疗组治疗后部分患者出现延长 ( 13 3 3 %~ 15 5 6% )及不凝现象( 2 2 2 2 %~ 2 4 4 4 % ) ,而对照组只有延长现象 ( 2 5 6%~ 5 13 % ) ,未出现不凝现象 (P <0 0 0 1)。血浆D -D :治疗组增高明显 ( P <0 0 0 1)。两组均未发现皮肤粘膜出血 ,消化道出血各 1例及死亡各 2例。结论 在目前研究方案下 ,国产降纤酶治疗急性脑梗死与对照组比较临床疗效无明显差异 ,但它能有效地降低血浆FIB ,改善血液高凝状态 。 展开更多
关键词 降纤酶 脑梗死 纤维蛋白原 急性脑梗死 药物疗法 疗效
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降纤酶治疗急性脑梗塞的疗效观察及血浆纤维蛋白原改变的初步讨探 被引量:16
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作者 姚声涛 陈佳琳 +4 位作者 田斌 杨友松 黄雨兰 沈岩松 杨宁 《贵州医药》 CAS 2003年第5期396-398,共3页
目的观察降纤酶治疗急性脑梗塞的疗效及血浆纤维蛋白原的改变 ,为进一步的临床研究提供一些参考依据。方法采用随机双盲、安慰剂对照的多中心临床试验的方法 ,将 85例急性脑梗塞患随机分为两组即研究组 (降纤酶组 )和对照组 (安慰剂组 ... 目的观察降纤酶治疗急性脑梗塞的疗效及血浆纤维蛋白原的改变 ,为进一步的临床研究提供一些参考依据。方法采用随机双盲、安慰剂对照的多中心临床试验的方法 ,将 85例急性脑梗塞患随机分为两组即研究组 (降纤酶组 )和对照组 (安慰剂组 ) ,于用药前后作神经功能缺损评分 ,并且检测血浆纤维蛋白原 (FIB) ,凝血酶原时间 (PT) ,血小板计数 (PLT) ,出血时间 (BT) ,凝血时间 (CT)。结果研究组的神经功能缺损程度明显改善 ,治愈率和有效率均高于对照组 (P <0 0 5或P <0 0 1 ) ;研究组血浆纤维蛋白原降低 ,在治疗后第 4、6、8、1 0天与对照组比较有显著差异 (P <0 0 1 ) ,用药前后PT、PLT、BT、CT均无明显变化。结论降纤酶治疗急性脑梗塞能明显改善神经功能 ,且有良好的安全性 ;控制血浆纤维蛋白原水平是治疗的关键。 展开更多
关键词 急性脑梗塞 降纤酶 纤维蛋白原 凝血酶原时间 血小板计数 出血时间 凝血时间 神经功能缺损评分
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银杏达莫注射液治疗急性脑梗死的疗效及对血液流变学和纤维蛋白原含量的影响 被引量:28
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作者 李世英 阎冰 夏静 《临床神经病学杂志》 CAS 北大核心 2008年第2期147-149,共3页
目的观察银杏达莫注射液治疗急性脑梗死的疗效及对血液流变学和纤维蛋白原含量的影响。方法将96例急性脑梗死患者随机分为两组,银杏达莫组(39例)给予银杏达莫注射液20ml加入生理盐水500ml静脉滴注,对照组(57例)给予血塞通注射液10ml加... 目的观察银杏达莫注射液治疗急性脑梗死的疗效及对血液流变学和纤维蛋白原含量的影响。方法将96例急性脑梗死患者随机分为两组,银杏达莫组(39例)给予银杏达莫注射液20ml加入生理盐水500ml静脉滴注,对照组(57例)给予血塞通注射液10ml加入生理盐水500ml静脉滴注,均每天1次;连用14d。于治疗前后分别进行神经功能缺损程度评分(评价临床疗效)、血液流变学指标和纤维蛋白原含量的检测及头颅CT检查。结果银杏达莫组总有效率(94.9%)明显高于对照组(78.9%)(P<0.05),银杏达莫组治疗后血液流变学指标和纤维蛋白原含量比治疗前显著下降(均P<0.05)。银杏达莫组与对照组治疗后头颅CT病灶缩小或密度改善分别为25例(71.4%)、24例(49.0%),差异有统计学意义(P<0.05)。对照组全血黏度(30s-1)、红细胞压积比治疗前明显降低(均P<0.05),其他与治疗前差异无统计学意义。结论银杏达莫注射液治疗急性脑梗死效果明显,并能明显改善急性脑梗死患者的血液流变学指标,使纤维蛋白原含量下降。 展开更多
关键词 急性脑梗死 银杏达莫注射液 血液流变学 纤维蛋白原
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急性脑梗死患者血浆纤维蛋白原和C反应蛋白水平的改变及其与病情和预后的关系 被引量:42
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作者 李凤山 王振海 刁士元 《临床神经病学杂志》 CAS 北大核心 2008年第2期100-102,共3页
目的探讨急性脑梗死(ACI)患者血浆纤维蛋白原(Fib)和C反应蛋白(CRP)水平的改变及其与病情和预后的关系。方法检测86例脑梗死患者(CI组)、27例腔隙性脑梗死患者(LCI组)和48名健康人(正常对照组)的血浆Fib及CRP含量。在CI患者入院当天和4... 目的探讨急性脑梗死(ACI)患者血浆纤维蛋白原(Fib)和C反应蛋白(CRP)水平的改变及其与病情和预后的关系。方法检测86例脑梗死患者(CI组)、27例腔隙性脑梗死患者(LCI组)和48名健康人(正常对照组)的血浆Fib及CRP含量。在CI患者入院当天和4周时进行临床神经功能缺损程度评分(NDS)评定。结果CI组和LCI组血浆Fib、CRP水平和异常率明显高于正常对照组(均P<0.01);NDS重型患者血浆Fib、CRP含量明显高于中型、轻型患者(均P<0.01);中型患者血浆CRP含量显著高于轻型患者(P<0.01)。血浆Fib和CRP含量异常组患者住院4周时显著进步和进步的比率明显低于正常对照组(均P<0.01),而无变化和死亡的比率明显高于正常对照组(均P<0.01)。结论ACI患者血浆Fib和CRP水平均明显升高,病情重的患者升高更明显;血浆Fib、CRP含量升高的患者预后较差。 展开更多
关键词 血浆纤维蛋白原 C反应蛋白 急性脑梗死
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降纤酶治疗急性脑梗死的临床再评价——前瞻性随机双盲对照研究 被引量:5
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作者 杨琴 承欧梅 +1 位作者 彭国光 董为伟 《重庆医科大学学报》 CAS CSCD 2004年第4期477-479,共3页
目的 :通过随机、双盲、安慰剂对照的临床研究 ,对降纤酶治疗急性脑梗死的有效性及安全性进行客观评价。方法 :将在我院神经内科就诊的 6 5例急性脑梗死病人随机分为降纤酶组和对照组。降纤酶的首剂量为 10U ,第 2、3次剂量为 5U ,在发... 目的 :通过随机、双盲、安慰剂对照的临床研究 ,对降纤酶治疗急性脑梗死的有效性及安全性进行客观评价。方法 :将在我院神经内科就诊的 6 5例急性脑梗死病人随机分为降纤酶组和对照组。降纤酶的首剂量为 10U ,第 2、3次剂量为 5U ,在发病 2 4h内开始治疗。对照组按同样方式给予安慰剂。评定的终点指标包括脑卒中的临床神经功能缺损程度评分、Barthel指数、副作用、血浆纤维蛋白原 (FIB)水平及发病 3个月和 1年时的病死率及脑卒中复发率。结果 :(1)与对照组比较 ,降纤酶组治疗后血浆FIB水平明显下降 (P <0 .0 0 1) ,没有增加出血事件及其他副作用的发生。 (2 )治疗后 14天神经功能缺损程度评分、3个月时Barthel指数评分及病死率 ,降纤酶组与对照组比较差异无显著性。 (3)随访 1年时 ,两组病死率比较 ,差异无显著性 ,但卒中复发率对照组高于降纤酶组 (P <0 .0 5 )。结论 :降纤酶是降解血浆FIB安全有效的药物。在本研究方案下 ,降纤酶未显示出优于目前治疗急性脑梗死 ,常用药物的临床疗效。其在适应证、治疗剂量。 展开更多
关键词 降纤酶 纤维蛋白原 脑梗塞
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巴曲酶治疗急性脑梗死临床疗效的Meta分析 被引量:8
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作者 程记伟 白宇 +3 位作者 张晓菁 候郁青 张利军 陈学芬 《中国康复理论与实践》 CSCD 北大核心 2013年第3期204-209,共6页
目的评价巴曲酶治疗急性脑梗死的临床疗效。方法检索有关巴曲酶治疗急性脑梗死的随机对照研究文献。采用Jadad评分评价纳入文献质量。采用RevMan 4.2软件进行Meta分析。结果共有38项研究纳入分析,其中阴性对照29篇,降纤酶对照6篇,尿激... 目的评价巴曲酶治疗急性脑梗死的临床疗效。方法检索有关巴曲酶治疗急性脑梗死的随机对照研究文献。采用Jadad评分评价纳入文献质量。采用RevMan 4.2软件进行Meta分析。结果共有38项研究纳入分析,其中阴性对照29篇,降纤酶对照6篇,尿激酶对照3篇。巴曲酶在有效率、降低神经功能缺损评分、降低纤维蛋白原方面优于阴性对照组(P<0.05),在神经功能缺损评分方面与尿激酶无显著性差异(P>0.05),在有效率方面与降纤酶无显著性差异(P>0.05)。结论巴曲酶可改善急性脑梗死患者神经功能缺损评分,降低纤维蛋白原水平。 展开更多
关键词 急性脑梗死 巴曲酶 META分析 神经功能 纤维蛋白原
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中药联合穴位埋线治疗急性脑梗死的临床研究 被引量:9
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作者 艾宗耀 李烨 +3 位作者 肖梅红 杨春华 王娅玲 王楠 《中华中医药学刊》 CAS 2014年第9期2262-2264,共3页
目的:探讨中药汤剂联合穴位埋线对急性脑梗死患者的临床疗效。方法:将75例急性脑梗死患者随机分成治疗组和对照组,其中对照组37例,治疗组38例,对照组予基本治疗,治疗组在基本治疗的基础上加用中药汤剂并联合穴位埋线治疗。取穴:廉泉、... 目的:探讨中药汤剂联合穴位埋线对急性脑梗死患者的临床疗效。方法:将75例急性脑梗死患者随机分成治疗组和对照组,其中对照组37例,治疗组38例,对照组予基本治疗,治疗组在基本治疗的基础上加用中药汤剂并联合穴位埋线治疗。取穴:廉泉、肩髃、曲池、合谷、环跳、足三里、丰隆、三阴交并检测治疗前后超敏-C反应蛋白、D-二聚体、纤维蛋白原,血液流变学指标;检测血脂;评定神经功能缺损评分及中医症候评分。疗程为2周。结果:两组治疗后hs-CRP,D-Dimer,Fig均较治疗前有下降,然而治疗组治疗后hs-CRP,D-Dimer,Fig较对照组治疗后下降明显,差异有统计学意义(P<0.05);治疗组治疗后血液流变学指标改善较对照组更明显(P<0.05)。两组血脂改变组间无差异(P>0.05);治疗后NIHSS及中医症候评分治疗组较对照组降低更为明显(P<0.05)。结论:中药联合穴位埋线治疗可显著改善急性脑梗死患者的神经功能缺损评分及中医症候评分,降低急性脑梗死患者血清中hs-CRP、D-Dimer、Fig含量,改善血液流变学指标,有一定的临床应用价值。 展开更多
关键词 急性脑梗死 中药 穴位埋线 HS-CRP 纤维蛋白原 D-二聚体 血脂
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MR灌注与弥散加权成像不同匹配与急性脑梗死降纤治疗效果的关系 被引量:7
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作者 陈国章 许祖梅 +2 位作者 林志坚 李梅芳 林鹏星 《临床神经病学杂志》 CAS 北大核心 2011年第5期341-344,共4页
目的探讨MR灌注加权成像(PWI)与弥散加权成像(DWI)(PWI/DWI)不同匹配与急性脑梗死降纤治疗效果的关系。方法给38例急性脑梗死患者行巴曲酶降纤治疗,在治疗前予以MR PWI及DWI检查,在治疗前和治疗后进行美国国立卫生研究院卒中量表(NIHSS... 目的探讨MR灌注加权成像(PWI)与弥散加权成像(DWI)(PWI/DWI)不同匹配与急性脑梗死降纤治疗效果的关系。方法给38例急性脑梗死患者行巴曲酶降纤治疗,在治疗前予以MR PWI及DWI检查,在治疗前和治疗后进行美国国立卫生研究院卒中量表(NIHSS)评分并评定疗效。比较PWI/DWI不同匹配患者治疗前后的NIHSS评分;采用Spearman等级相关分析对PWI/DWI不同匹配(PWI>DWI、PWI/DWI正常、PWI<DWI、PWI=DWI)与降纤治疗效果(基本痊愈、显著进步、进步、无变化、恶化)的关系进行分析。结果本组患者中PWI>DWI 20例、PWI=DWI 11例、PWI<DWI 4例、PWI/DWI正常3例。PWI>DWI组、PWI/DWI正常组治疗后NIHSS评分比治疗前显著降低(P<0.001,P=0.003),而PWI<DWI组和PWI=DWI组治疗前后NIHSS评分比较,差异无统计学意义(P=0.080,P=0.229)。Spearman等级相关分析显示,PWI/DWI不同匹配与降纤治疗效果呈正相关(r=0.733,P<0.001)。结论 MR PWI/DWI不同匹配与急性脑梗死降纤治疗效果有显著关系,PWI>DWI和PWI/DWI正常的患者降纤治疗的效果较好,而PWI=DWI及PWI<DWI患者降纤治疗无明显效果。PWI/DWI匹配状况可用于指导脑梗死的降纤治疗。 展开更多
关键词 灌注加权成像 弥散加权成像 急性脑梗死 降纤治疗
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纤溶酶治疗急性脑梗死时效性 被引量:6
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作者 程记伟 白宇 +2 位作者 张利军 张晓菁 侯郁青 《医药导报》 CAS 2016年第8期849-853,共5页
目的探讨纤溶酶治疗急性脑梗死时效关系及其对血浆纤维蛋白原(FIB)及血栓前体蛋白(Tp P)水平影响。方法采用随机单盲安慰药对照试验设计。选取发病≤12 h的急性脑梗死患者150例,随机分为试验A组(A组,发病后12 h给予纤溶酶)、试验B组(B组... 目的探讨纤溶酶治疗急性脑梗死时效关系及其对血浆纤维蛋白原(FIB)及血栓前体蛋白(Tp P)水平影响。方法采用随机单盲安慰药对照试验设计。选取发病≤12 h的急性脑梗死患者150例,随机分为试验A组(A组,发病后12 h给予纤溶酶)、试验B组(B组,发病后24 h给予纤溶酶)及对照组(C组,不予纤溶酶),每组各50例。试验A组及B组给予脑梗死基础治疗+纤溶酶治疗,对照组给予脑梗死基础治疗+安慰药。通过观察比较3组患者治疗前及治疗7 d后FIB及Tp P水平、治疗前及治疗14 d后美国国立卫生研究院卒中量表(NIHSS)评分值、治疗前及治疗90 d后患者Bathel指数(BI)、进展性脑卒中发生率、治疗90 d及1年后患者脑卒中复发率及脑卒中病死率,分析评价纤溶酶临床疗效;通过观察比较治疗前及治疗7 d后患者肝肾功能、出血发生率及患者皮试过敏率了解纤溶酶安全性。结果 1 NIHSS评分比较:3组治疗后NIHSS评分为A组(4.0±1.6),B组(6.5±2.2),C组(8.0±4.7)。与治疗前比较,3组NIHSS评分均明显下降(P<0.05);A组及B组较C组下降明显(P<0.05);A组较B组下降更明显(P<0.05)。2BI评分比较:3组治疗后BI评分为A组(68.5±30.6),B组(55.6±29.2),C组(49.7±28.9)。与治疗前比较,3组BI评分均明显提高(P<0.05);A组较B组、C组提高明显(P<0.05)。3进展性脑卒中发生率比较:A组、B组及C组进展性脑卒中发生率分别为4.0%,20.0%及30.0%。A组进展性脑卒中发生率较B组、C组低(P<0.05)。4脑卒中复发率及病死率比较:3组患者治疗后90 d脑卒中复发率为A组(6.3%),B组(8.3%),C组(25.5%),治疗后1年脑卒中复发率为A组(10.4%),B组(14.5%),C组(31.9%)。A组及B组治疗后90 d及1年脑卒中复发率较C组明显降低(P<0.05)。3组脑卒中病死率差异无统计学意义(P>0.05)。5FIB及Tp P水平比较:3组治疗后FIB分别为A组(2.74±0.75)g·L^(-1),B组(2.82±0.83)g·L^(-1),C组(3.67±1.35)g·L^(-1)。与治疗前比较,A组、B组患者治疗后FIB水平无明显下降(P>0.05);但A组及B组FIB较C组下降(P<0.05)。3组治疗后Tp P分别为A组(3.56±1.26)mg·L^(-1),B组(3.43±1.22)mg·L^(-1),C组(13.21±6.54)mg·L^(-1)。与治疗前比较,3组患者治疗后Tp P水平明显下降(P<0.05);A组及B组Tp P水平较C组下降更明显(P<0.05)。安全性指标:纤溶酶无明显肝肾损伤,不增加出血风险,过敏发生率低。结论脑梗死发病24 h内接受纤溶酶治疗均能安全获益,但发病后12 h给药较发病后24 h给药获益明显增多。纤溶酶主要通过降低Tp P发挥抗栓作用,对FIB影响较小。 展开更多
关键词 纤溶酶 纤维蛋白原 血栓前体蛋白 脑梗死 急性 时效性
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