尤瑞克林对急性脑梗死患者脑循环动力学的影响

目的 观察尤瑞克林治疗急性颈内动脉系统脑梗死患者的临床疗效及其对患侧脑循环动力学的影响。方法 急性单侧颈内动脉系统脑梗死患者78例，随机分为尤瑞克林治疗组和对照组。两组均给予抗血小板药物等常规治疗，治疗组另加用尤瑞克林治疗，疗程14d。在治疗前、后分别用美国国立卫生研究所脑卒中评分（National Institutes of Health Stroke Scale，NIHSS）评估两组患者的神经功能缺损程度，检测两组患者的脑循环动力学指标（cerebralvascular dynamics indexes，CVDI），比较两组之间及治疗前后神经功能及脑循环动力学变化。结果 急性脑梗死患者经尤瑞克林治疗后神经功能恢复明显优于对照组，NIHSS评分、临床总有效率均显著改善（P<0.05）。两组患者治疗后患侧颈动脉最小血流速度、平均血流速度、最小血流量及平均血流量均较治疗前明显增加（P<0.05，P<0.01），外周阻力均有所下降（P<0.01）；治疗组治疗后最小血流速度、平均血流速度、最小血流量及平均血流量的增加及外周阻力的下降均较对照组更明显（P<0.01）。治疗组治疗后的血管特性阻抗显著降低（P<0.01）。结论 尤瑞克林能改善急性脑梗死患者脑循环动力学指标，降低脑血管的阻力，增加脑动脉的供血量，促进神经功能恢复。

Effect of Urinary Kallidinogenase on Hemodynamics of Cerebral Circulation in Patients with Acute Cerebral Infarction

Objective To observe the effect of urinary kallidinogenase on recovery of neurological function and hemodynamics of cerebral circulation in patients with acute cerebral infarction（ACI） of internal carotid artery system.
Methods Seventy-eight patients with acute cerebral infarction of unilateral carotid artery system were randomly divided into urinary kallidinogenase treatment group（39 cases） and control group（39 cases）. All the patients were received routine treatment including antiplatelet drugs. Patients in the urinary kallidinogenase treatment group were additionally received urinary kallidinogenase for 14 days. Before treatment and 14 days after treatment, the degrees of neurological impairment of the two groups were evaluated with National Institutes of Health Stroke Scale（NIHSS）, the cerebrovascular dynamics indexes（CVDI） of both groups were detected. The changes of NIHSS scales and CVDI after treatment in each group and between the two groups were analyzed.
Results The neurological functional recovery of the kallidinogenase treatment group was notably surpassed that of the control group, and there were significant difference of total effective rate and the NIHSS score between the two groups（P〈0.05）. The minimum velocity（Vmin）, mean velocity（Vmean）, minimum quantity（Qmin） and mean quantity（Qmean） of affected carotid artery in the two groups after treatment were significantly increased（P〈0.05, P〈0.01） and the cerebrovascular resistance（R） was notably decreased than that before treatment（P〈0.01）, and the changes of these indexes in the urinary kallidinogenase treatment group were more significantly than that in the control group（P〈0.01）. The characteristic impedance（Zc） in the trearment groups was remarkably decreased after treatment（P〈0.01）.
Conclusion Urinary kallidinogenase could improve CVDI of ACI patients, decrease the cerebrovascular resistance, increase cerebral blood velocity and flow, and effectually promote the recovery of neurological functions.