Reassessment of Defibrase in the treatment of Acute Cerebral lnfarction

Objective: to assess the safety and efficacy of defibrase in the treatment of acute cerebral iinfarction by a large sample, multicerter, randomized, double-blind, and placebo-controlled clinical trial Methods: 2244 cases with acute infarction in 41centers were randomly allocated to receive either an imitial intrdvcnons infusion of defibrase 10Bu or placebo in 250ml of normal saline within 24 hours of stroke onset Subsequent in fusions of defibrase 5Bu or placebo on the third and fifth days respectively. This treatment protocol was determined on the bases of the pretrial of 114 patientsin 8 centers The end points fincluded Climcally Neurological De ficits Scale of Stroke, Barthel Index, Mortality, adverse reaction and the level of plasma fibrinogen (FIB)Results: (1) the level of plasma FIB in defibrase group was reurarkably declied after treatment whereas the bleeding evcnts and other adverse reaction was not incteased in comparison with control group There was difference in the imtcnsity of degrading plasna FIB between defibrase from Agkistrodon halys and that frorn Agkistrodon acutns. (2) Theare were no statistically significant differences at Clinically Neurological Deficits Scale of Stroke at 2 weeks, Barthel Index sc ore and mortality at 3 months between two groups. Conclutions: This study showed that defibrase atppears safe and effective in degading plastua FIB.The dose of defibrase should regnlate propcrly according to preparations from diffcrent snake venom .This study did not show that clinical efficacy of defibrase was supetior to those present used medicines for acute cerebral infarction It is necessary to further study about the relations between its clinical efficacy and the dose,protocol of drug administration and indication.     

醒脑开窍针刺超早期急性脑梗死患者血浆神经肽Y水平：随机对照

BACKGROUND： It is known that acupuncture therapy can decrease plasma neuropeptide Y （NPY） levels in patients with cerebral infarction, but different types of acupuncture therapy used in various stages of cerebral infarction have not been evaluated.
OBJECTIVE： To explore the effect of acupuncture therapy on resuscitation （Xingnao Kaiqiao） and plasma NPY levels in patients with very early stage acute cerebral infarction. DESIGN, TIME AND SETTING： This case-controlled study was
performed at the Affiliated Hospital of the Medical College of the Chinese People＇s Armed Police Force between September 2004 and October 2005.
PARTICIPANTS： Sixty patients with acute cerebral infarction of ≤ 6 hours were used in this study. Patients were randomly divided into an acupuncture therapy group （n = 30） and a routine treatment group （n = 30）. Another 30 healthy subjects were used as the control group.
METHODS： The acupuncture therapy of Xingnao Kaiqiao used in the acupuncture therapy group was based on routine western medical treatment and was performed at bilateral Neiguan （PCG） using the twirling, reinforcing-reducing method, Renzhong （DU26） using heavy bird-pecking needling, Sanyinjiao （SPG） using reinforcing and reducing by lifting and thrusting the needle, Jiquan （HT1）, Weizhong （BL40） and Chize （LU5） using reinforcing and reducing by lifting and thrusting the needle. The acupuncture lasted for 14 days. Patients in the routine treatment group underwent routine medical treatment and no intervention was given to subjects in the control group.
MAIN OUTCOME MEASURES： A 4 mL venous blood sample was obtained at different time points, i.e., immediately after hospitalization, the next morning, 7 and 14 days after treatment, to measure plasma NPY levels pre- and post-treatment using the radio-immunity method.
RESULTS： The plasma NPY levels were significantly higher in both the routine treatment group and the acupuncture therapy group than in the control group pre- and post-treatment （P 〈 0.01）. In particular, the plasma NPY levels in both the acupuncture therapy group and the routine treatment group were increased 7 days post-treatment but decreased from 7-14 days post-treatment. In addition, the plasma NPY levels were significantly lower in the acupuncture therapy group than in the routine treatment group on day 7 and 14 post-treatment （P 〈 0.01）.
CONCLUSION： Acupuncture therapy of Xingnao Kaiqiao can decrease plasma NPY levels in patients with very early stage acute cerebral infarction. In addition, the therapeutic effect of acupuncture with a prolonged therapy time is superior to routine treatment.     

急性动脉粥样硬化性脑梗死患者血清脑红蛋白水平的意义

This study sought to examine neuroglobin (NGB) in the serum of acute cerebral infarction patients with double-antibody sandwich enzyme-linked immunosorbent assay to identify all risk factors, calculate infarct size, assess neurological impairment, and analyze the relation between NGB and each of these factors. The double-antibody sandwich assay indicated that levels of NGB in serum were unaltered within 6 hours following acute cerebral infarction compared with normal levels. NGB levels then underwent a distinct change, peaking at 24 hours then returning to normal levels in 72 hours. The results suggest that the level of NGB might be related to infarct size and low-density lipoprotein at 24 hours after acute cerebral infarction. There were no significant differences in neurological impairment scores and infarct size at different periods following infarction. The findings indicated that the level of NGB in serum of acute cerebral infarction patients was correlated with infarct time.     

Xueshuantong improves cerebral blood perfusion in elderly patients with lacunar infarction

A total of 64 patients with acute lacunar infarction were enrolled within 24 hours of onset. The patients received conventional therapy (antiplatelet drugs and hypolipidemic drugs) alone or conventional therapy plus 450 mg Xueshuantong once a day. The main ingredient of the Xueshuantong lyophilized powder used for injection was Panax notoginseng saponins. Assessments were made at admission and at discharge using the National Institutes of Health Stroke Scale, the Activity of Daily Living and the Mini-Mental State Examination. Additionally, the relative cerebral blood flow, relative cerebral blood volume and relative mean transit time in the region of interest were calculated within 24 hours after the onset of lacunar infarction, using dynamic susceptibility contrast magnetic resonance perfusion imaging technology. Patients underwent a follow-up MRI scan after 4 weeks of treatment. There was an improvement in the Activity of Daily Living scores and a greater reduction in the scores on the National Institutes of Health Stroke Scale in the treatment group than in the control group. However, the Mini-Mental State Examination scores showed no significant differences after 4 weeks of treatment. Compared with the control group, the relative cerebral blood flow at discharge had increased and showed a greater improvement in the treatment group. Furthermore, there was a reduction in the relative mean transit time at discharge and the value was lower in the treatment group than in the control group. The experimental findings indicate that Xueshuantong treatment improves neurological deficits in elderly patients with lacunar infarction, and the mechanism may be related to increased cerebral perfusion.     

Correlating plasma endothelin-1 and beta-endorphin levels to nine risk factors of acute cerebral infarction★

BACKGROUND： Several studies have confirmed that endothelin and endorphin are involved in the occurrence of cerebral vasospasm. However, the correlation of these factors to acute cerebral infarction-related risk factors needs to be confirmed. OBJECTIVE： To detect endothelin-1 （ET-1） and beta-endorphin （β -EP） levels in plasma of patients with acute cerebral infarction, and to analyze the correlations of these factors to smoking, alcohol abuse, hypertension, diabetes mellitus, diseased region, diseased degree, gender, and other factors related to acute cerebral infarction. DESIGN： A case-control observation.
SETTING： First Department of Neurology, Guangdong Hospital of Traditional Chinese Medicine; Department of Neurology, Second Affiliated Hospital of Sun Yat-sen University. PARTICIPANTS： Sixty-nine inpatients with acute cerebral infarction were admitted to the Department of Neurology, Second Affiliated Hospital of Sun Yat-sen University （March 2003-January 2004） and First Department of Neurology, Guangdong Hospital of Traditional Chinese Medicine （March July 2004） and recruited for this study. All 69 inpatients corresponded to the diagnosis criteria of acute cerebral infarction, formulated in the National Working Conference of Cerebrovascular Disease in 1998, and were confirmed as acute cerebral infarction by CT/MRI. The patient group consisted of 35 males [（644- 12） years old] and 34 females[ （674- 13 ） years old]. Among them, 9 patients were smokers, 7 were alcohol users, 48 had a history of hypertension, and 16 had a history of diabetes mellitus. CT/MRI examinations revealed that 35 patients presented with left focus sites, 11 with right ones and 23 with bilateral ones. Following attack, 24 patients had Barthel Index Scale grading 〈 40 points, 21 patients 40-50 points, and 24 patients 〉 60 points. An additional 59 healthy individuals, who received health examinations simultaneously, were included as controls. Among the control subjects, there were 37 males [（62±10）     

Effect of extracranial electric stimulation at cerebellar fastiglal nucleus on serum C-reactive protein of patients with acute cerebral infarction

BACKGROUND: Some reports indicate that electric and/or chemical stimulation at various brain sites of experimental animals can raise regional cerebral blood flow and improve cerebral circulation; however, its mechanism is still unclear. OBJECTIVE: To observe the effects of electric stimulation at cerebellar fastigial nucleus on serum C-reactive protein of patients with acute cerebral infarction. DESIGN: Non-randomized synchronized contrast study. SETTING: The Second People's Hospital of Xinxiang City. PARTICIPANTS: A total of 54 patients with acute cerebral infarction were selected from the Department of Neurology, the Second People's Hospital of Xinxiang from December 2005 to December 2006. There were 31 males and 23 females, and their ages ranged from 56 to 80 years. All patients met the diagnostic criteria of the Fourth National Cerebrovascular Academic Meeting, were finally diagnosed by using CT examination, and provided the confirmed consent. Based on therapeutic demands, patients were divided into electric stimulation group and routine treatment group with 27 cases in each group. In addition, 21 healthy subjects, including 11 males and 10 females and aging 53–78 years, were selected as the control group. All the subjects in the control group did not have any histories of cerebrovascular diseases and severe body diseases. METHODS: Based on routine drug therapy, patients in the electric stimulation group were also treated by using CVFT-010M cerebral circulation function therapeutic device (made in Shanghai). Electrode was fixed at bilateral mastoid in the first group and at extensible sides of upper limbs in the second group. Electric stimulation was given twice a day and lasted for 30 minutes each time. Ten days were regarded as a course. Parameters of device: mode Ⅲ, frequency 198%, and intensity 90%–110% (bionic current). Patients in the routine treatment group received the routine drug treatment. Content of serum C-reactive protein was measured in both electric stimulation group and routine treatment group before treatment and at 20 days after treatment, while in the control group on the exact day of health examination by using immunization. MAIN OUTCOME MEASURES: Level of serum C-reactive protein in the three groups. RESULTS: All 54 patients with acute cerebral infarction and 21 healthy subjects were involved in the final analysis. Level of serum C-reactive protein was higher in both electric stimulation group and routine treatment group than that in the control group before treatment (P < 0.01). While, level of serum C-reactive protein was lower in the electric stimulation group than that in the routine treatment group after electric stimulation at cerebellar fastigial nucleus (P < 0.01). CONCLUSION: Electric stimulation at cerebellar fastigial nucleus can decrease level of serum C-reactive protein in patients with acute cerebral infarction, and this may be one of the therapeutic mechanisms for curing acute cerebral infarction.     

疏血通注射液治疗急性脑梗死患者的临床观察及其对血清C反应蛋白的影响

Objective To observe the curative effects of Shuxuetong in treating patients with acute cerebral infarction and its effects on the level of serum C-reactive protein (CRP).Methods One hundred and twenty patients with acute cerebral infarction who had the onset within 48 h were equally randomized into treatment group and control group.Six ml Shuxuetong and Troxerutin for intravenous drip daily were given to the treatment group and the control group,respectively,for a consecutive 14 d.The concentrations of serum CRP in the 2 groups were measured by immunonephelometry before treatment and on the 5th,10th and 14th d of treatment.The scores of neurological functional deficit scale were compared before treatment and on the 14th d of treatment in the 2 groups.Results The concentration of serum CRP in the treatment group on the 5th,10th and 14th d of treatment was significantly lower than that in the control group (P<0.05).The scores of neurological functional deficit scale in the treatment group (14.57±7.88) were significantly lower than those in the control group (19.08±8.11) (P<0.05).The clinical efficacy between the 2 groups was obviously different (P<0.05).Conclusion Shuxuetoug can decrease the concentration of serum CRP and improve the nervous function in patients with acute cerebral infarction.     

Plasma thrombomodulin changes in acute cerebral infarction or hypertension patients*★ An observation for verification

BACKGROUND： Thrombomodulin concentration greatly increases in plasma when vascular endothelial cells are injured, and it is one of the specific molecular markers for endothelial injury. OBJECTIVE： To analyze the plasma levels of thrombomodulin after cerebral infarction or hypertension, and to compare levels with those from healthy control subjects. DESIGN： A case-controlled observation. SETTING： Yuquan Hospital of Tsinghua University. PARTICIPANTS： Patients with hypertension （n = 37） and acute cerebral infarction （n = 26） were selected from the outpatient and inpatient Department of Neurology, Yuquan Hospital of Tsinghua University from February 2003 to February 2006. The cerebral infarction group consisted of 24 males and 2 females, 36-77 years of age, with a mean age of 62 years. All patients fulfilled the diagnosis criteria for cerebral infarction, according to the diagnostic standards revised by the Second National Academic Meeting for Cerebrovascular Disease, and were confirmed by CT or MRI. The hypertension group consisted of 27 males and 10 females, 36-77 years of age, with a mean age of 56 years. These patients fulfilled the diagnostic criteria for hypertension set by WHO. In addition, 43 healthy physical examinees were selected as the control group, consisting of 23 males and 20 females, 35-67 years of age. Informed consent was obtained from all participants. METHODS： In the cerebral infarction group, thrombomodulin plasma levels were determined by enzyme-linked immunoabsorbent assay at days 1, 3, 7, and 14 after attack. Thrombomodulin plasma levels were determined only once in the hypertension group and the control group. The results from the cerebral infarction group were compared with those from the hypertension group and the control group. MAIN OUTCOME MEASURES： Level of thrombomodulin in plasma. RESULTS： All 63 patients and 43 healthy volunteers were included in the final analysis of results. （1） At 7 days after the attack, the plasma levels of thrombomodulin in the cereb     

疏血通注射液治疗急性脑梗死患者的临床观察及其对血清C反应蛋白的影响

Objective To observe the curative effects of Shuxuetong in treating patients with acute cerebral infarction and its effects on the level of serum C-reactive protein (CRP).Methods One hundred and twenty patients with acute cerebral infarction who had the onset within 48 h were equally randomized into treatment group and control group.Six ml Shuxuetong and Troxerutin for intravenous drip daily were given to the treatment group and the control group,respectively,for a consecutive 14 d.The concentrations of serum CRP in the 2 groups were measured by immunonephelometry before treatment and on the 5th,10th and 14th d of treatment.The scores of neurological functional deficit scale were compared before treatment and on the 14th d of treatment in the 2 groups.Results The concentration of serum CRP in the treatment group on the 5th,10th and 14th d of treatment was significantly lower than that in the control group (P<0.05).The scores of neurological functional deficit scale in the treatment group (14.57±7.88) were significantly lower than those in the control group (19.08±8.11) (P<0.05).The clinical efficacy between the 2 groups was obviously different (P<0.05).Conclusion Shuxuetoug can decrease the concentration of serum CRP and improve the nervous function in patients with acute cerebral infarction.     

Magnetic resonance diffusion tensor imaging following major ozonated autohemotherapy for treatment of acute cerebral infarction

Major ozonated autohemotherapy has been shown to promote recovery of upper limb motor function in patients with acute cerebral infarction,but whether major ozonated autohemotherapy affects remote injury remains poorly understood.Here,we assumed that major ozonated autohemotherapy contributes to recovery of clinical function,possibly by reducing remote injury after acute cerebral infarction.Sixty acute cerebral infarction patients aged 30–80 years were equally and randomly allocated to ozone treatment and control groups.Patients in the ozone treatment group received medical treatment and major ozonated autohemotherapy(47 mg/L,100 m L ozone) for 10 ± 2 days.Patients in the control group received medical treatment only.National Institutes of Health Stroke Scale score,modified Rankin scale score,and reduced degree of fractional anisotropy values of brain magnetic resonance diffusion tensor imaging were remarkably decreased,brain function improved,clinical efficiency significantly increased,and no obvious adverse reactions detected in the ozone treatment group compared with the control group.These findings suggest that major ozonated autohemotherapy promotes recovery of neurological function in acute cerebral infarction patients by reducing remote injury,and additionally,exhibits high safety.     

降纤酶治疗急性脑梗死的疗效评价

目的 本文通过随机、对照、开放性临床研究,对海王降纤酶治疗急性脑梗死的有效性及安全性进行评价。方法 将90例急性脑梗死病人按2:1随机分为试验组和对照组,两组均以低分子右旋糖酐作为基础治疗。试验组加用降纤酶静脉给药,首剂量10 IU,其后5 IU隔日1次,共3次,总剂量20 IU。结果 与对照组比较,降纤组治疗后血浆FIB水平明显下降(P<0.001)。在降纤治疗过程中,有2例颅内出血发生,没有死亡病例,两组出血的差异无显著性。治疗后14天神经功能缺损恢复程度明显优于对照组(P<0.01)。结论 降纤酶是一种治疗急性脑梗死较为安全有效的药物。     

急性脑梗死患者凝血-纤溶系统分子标记物的变化及前列腺素E1对其影响的研究

目的：探讨急性脑梗死患的血管内皮损伤情况，血小板的活化情况，纤溶，抗纤溶及血黏度状态，探讨脂化前列腺素E1（凯时注射液）对脑梗死患的作用影响及观察临床疗效。方法：选择急性期脑梗死患与健康人，对vWF,GMP-140,FIB,t-PA,PAI指标进行测定并进行对比分析。对脑梗死患应用凯时治疗，对治疗前后的上述指标进行分析。并进行神经功能缺损评分，结果：脑梗死患存在血管内皮损伤，血小板活化，血液有高凝状态，该状态经凯时治疗后，可以得到明显改善，且脑梗死患的神经功能缺损评分明显改善。结论：凯时可以减轻脑梗死造成的血管内皮损伤，血小板高度活化，降低血黏度，对脑梗死有较好的疗效。     

抗血小板药物对急性非心源性脑梗死患者血浆溶血磷脂酸的影响

目的 观察抗血小板药物阿司匹林和氯吡格雷对急性非心源性脑梗死患者血浆溶血磷脂酸（lysophosphatidic acid,LPA）水平的影响。方法 选取急性脑梗死患者180例,随机分为阿司匹林组和氯吡格雷组,阿司匹林组在常规治疗的基础上加用拜阿司匹林0.1g,每天一次,氯吡格雷组在常规治疗的基础上加用氯吡格雷75mg,每天一次。两组分别于治疗前和治疗后第12～14天测定血浆LPA。另设正常对照组50名,均为我院健康体检者。结果 脑梗死组LPA水平明显高于对照组（3.80±0.87μmol/L vs 2.85±0.65μmol/L,P <0.01）;与治疗前相比,阿司匹林组和氯吡格雷组治疗后LPA水平均明显降低（3.26±0.50μmol/L vs 3.79±0.83μmol/L,P <0.01;3.06±0.69μmol/L vs 3.82±0.90μmol/L,P <0.01）,但氯吡格雷组降低更明显（P <0.01）。结论 急性脑梗死患者血中LPA水平高于正常人;抗血小板药物阿司匹林、氯吡格雷均能显著降低急性脑梗死患者LPA,其中氯吡格雷较阿司匹林更明显。     

水蛭素和阿司匹林合用对脑梗死患者凝血功能影响的研究

目的:研究脑梗死患者同时服用水蛭素和阿司匹林对凝血功能的影响。方法:收集了经头颅CT或MRI证实的脑梗死患者120例,分为对照组和观察组。对照组:60例(男38例,女22例)单独服用阿司匹林100mg·d-1。观察组:60例(男40例,女20例)服用水蛭素每次0·32g,tid,合用阿司匹林100mg·d-1共4周。观察用药前、后凝血酶原时间(PT),部分凝血活酶时间(APTT),纤维蛋白原(FIB),血小板计数(PLT)的变化。结果:对照组服药前、后PT、FIB、PLT及APTT无明显变化。观察组服药前、后PT、FIB及PLT的变化无统计学差异(P>0·05),但APTT的变化有统计学差异(P<0·05),说明观察组对APTT有影响。临床观察无一例出血现象。结论:水蛭素与阿司匹林合用对脑梗死患者的APTT有影响,但对其他凝血功能无明显的影响。     

降纤酶治疗脑梗死的实验研究

目的观察降纤酶对光化学模型诱导的大鼠大脑中动脉血栓的溶栓作用及对脑梗死灶的影响.方法应用光化学方法造成60只易卒中型肾血管性高血压大鼠(RHRSP)大脑中动脉(MCA)血栓形成,在3h、6h、9h、12h、1d不同的时间点对大鼠静脉注射3种产地的降纤酶8U/kg,对照组注射等容生理盐水,观察2d,对大鼠进行行为学评分、MCA血流测定、梗死灶体积测定、病理改变及出血情况观察.结果降纤酶组3小时以内的血栓全部溶解,6小时内的部分溶解.降纤酶组各时间点无论血栓溶解与否,大鼠的行为学评分、梗死灶体积均较生理盐水组低,梗死灶周围微血管闭塞较生理盐水组少.但在降纤酶组中有2例发生出血,分别发生于血栓后6h、12h用药组.结论降纤酶对6小时以内的血栓有溶栓作用,对3小时以内的血栓溶解率最高.降纤酶除溶栓作用外,还可减少梗死灶体积,抑制微血管的血栓形成,改善微循环,改善卒中的预后.与其他溶栓剂相比并不增加出血并发症的发生.     

急性脑梗死患者血清基质金属蛋白酶-2、基质金属蛋白酶组织抑制因子-2的变化及其意义

目的观察急性脑梗死患者血清基质金属蛋白酶-2（MMP-2）及基质金属蛋白酶组织押制因子-2（TIMP-2）水平的变化，探讨其在急性脑梗死的发病机制中的作用及临床意义。方法采用酶联免疫吸附法对56例急性脑梗死患者（CI组）及49例健康时照组（NC组）进行血清MMP-2、TIMP-2测定。结果CI组血清MMP-2水平在发病后呈先增高后降至NC组水平的趋势，病程〈24h、2～5d、28d分别为（46.29±14．37）μg／L、（62．18±12．32）μg／L、（35．72±8．91）μg／L，其中以2～5d时最高，与CI组病程〈24h、28d、NC组比较有显著性差异（P〈0．05）。CI组血清TIMP-2水平在病程〈24h、2～5d、28d分别为（186．14±27．91）μg／L、（160．62±25．49）μg／L、（189．01±33．17）μg／L，其中以2～5d时最低，与CI组病程〈24h、28d、NC组比较有显著性差异（P〈0．05）。结论急性脑梗死患者存在血清MMP-2、TIMP-2水平异常，提示MMP-2、TIMP-2参入脑梗死病理过程。     

次乌头碱对脑梗死大鼠神经功能与血清中t-PA,PAI-I含量水平的影响

目的通过建立脑梗死大鼠模型,探讨次乌头碱对神经功能与脑梗死大鼠血清中t-PA,PAI-I含量水平的影响。方法大鼠随机分为假手术组(Sham),脑梗死组(CI),次乌头碱低剂量组(HA-L)、中剂量组(HA-M)和高剂量组(HA-H),采用线栓法建立大鼠脑动脉闭塞模型,建模成功后,次乌头碱低剂量组、中剂量组和高剂量组分别给予次乌头碱灌胃0.25 mg/kg,0.75 mg/kg与2.25 mg/kg,每天1次,共给药3 d。给药完成后,对各组大鼠进行神经功能缺损评分,ELISA检测血清中组织型纤溶酶原激活物(t-PA)和纤溶酶原激活抑制物(PAI-I)的含量水平,TTC染色检测脑梗死体积,免疫印迹法检测ICAM-1与VCAM-1蛋白表达水平。结果与脑梗死组相比,采用次乌头碱给药后,脑梗死大鼠的神经功能缺损评分显著降低,血清中t-PA与PAI-I的含量水平明显下降,脑梗死面积降低,脑组织中ICAM-1与VCAM-1蛋白表达明显下降。结论次乌头碱能够改善脑梗死大鼠的神经功能缺损状态,可能与其影响纤溶系统以及ICAM-1与VCAM-1因子表达有关。     

国产降纤酶治疗急性脑梗死的评价

目的　评价国产降纤酶治疗急性脑梗死的疗效及安全性。方法　采用前瞻性随机双盲对照方法 ,2 8例患者随机分两组。治疗中监测纤维蛋白原水平、凝血酶原时间及凝血酶原活动度。评估指标包括临床神经功能缺损程度评分、Barthel指数、安全性及治疗一年后患者卒中复发率。结果　 ( 1)治疗 14d临床神经功能缺损程度评分和Barthel指数 ,降纤酶组与对照组相比有显著性差异 (P <0 0 5 ) ,1年后两组卒中复发率有显著性差异。降纤酶组没有增加出血事件及肝肾功能损害等不良反应。 ( 2 )用药后降纤酶组与同期对照组纤维蛋白原、凝血酶原时间及凝血酶原活动度有显著性差异 (P <0 0 5 )。结论　降纤酶是降解纤维蛋白原安全有效的药物 ,可改善急性期临床神经功能评分及Barthel指数     

巴曲酶治疗超早期急性脑梗死的临床观察

目的观察不同剂量巴曲酶治疗急性脑梗塞不同疗程的疗效。方法急性脑梗塞患者51例,随机分为巴曲酶常规剂量治疗组(24例)和大剂量延长疗程组(27例),观察两组治疗后7天及14天的神经功能缺损评分及纤维蛋白原含量。结果大剂量延长疗程组患者治疗后7天及14天ESS评分与常规剂量组相比,有显著改善。但两组血浆纤维蛋白原水平无明显差别。各组治疗后7天血浆纤维蛋白原水平较治疗前显著降低,治疗后14天血浆纤维蛋白原水平与治疗前相比无显著变化。结论巴曲酶能够改善急性脑梗死患者的预后,提高患者的生活质量,是治疗急性脑梗死有效药物之一。     

阿托伐他汀对急性颈内动脉系统脑梗死患者基质金属蛋白酶-9的影响

目的 观察阿托伐他汀对急性脑梗死患者血清基质金属蛋白酶-9（matrix metalloproteinase-9,MMP-9）的影响。方法 入选急性脑梗死患者128例,根据入院后颈动脉彩超结果,分为颈动脉粥样硬化（atherosclerosis,AS）稳定斑块组51例、颈动脉AS易损斑块组46例,无斑块组31例。各组给予阿托伐他汀20mg/d口服干预治疗,疗程2周。比较治疗前及治疗2周后患者血清MMP-9水平变化。结果 ①治疗前易损斑块组和稳定斑块组血清MMP-9浓度分别为（419.93±113.12）μg/L和（271.45±80.34）μg/L,均高于无斑块组（147.36±23.62）μg/L,易损斑块组也高于稳定斑块组（均P＜0.01）。②阿托伐他汀治疗2周后易损斑块组、稳定斑块组及无斑块组血清MMP-9水平分别下降至（242.58±101.63）μg/L、（191.36±79.28）μg/L和（126.72±22.86）μg/L,与本组治疗前相比,差异具有统计学意义（均P＜0.01）。结论 急性脑梗死患者中血清MMP-9的水平与AS斑块的发生和稳定性相关,阿托伐他汀治疗能显著降低急性颈内动脉系统脑梗死患者MMP-9水平。