人尿激肽原酶治疗TOAST分型急性脑梗死的效果

目的分型探讨人尿激肽原酶(尤瑞克林)治疗急性脑梗死的临床疗效。方法对169例急性脑梗死住院患者给予尤瑞克林治疗(除常规治疗外,静滴尤瑞克林0.15PNA单位/d)14d,结合TOAST分型观察各组治疗前后中心区及半暗带区脑灌注成像相对比值,对比各组治疗效果及治疗前后神经功能缺损评分(NIHSS)。同时进行颈动脉、椎动脉和心脏彩色多普勒超声,心电图(动态心电图),以及头颅和颈部MRI/MRA等检查;并行血常规、血糖、血脂、肝功能、肾功能、心肌酶谱、凝血常规等检测。结果大动脉粥样硬化性脑梗死(LAA)中心区及半暗带区的脑血容量(CBV)、脑血流量(CBF)、达峰时间(TTP)均明显高于治疗前(P0.05),与小动脉闭塞性(SAO)、心源性(CE)、其他原因(SOE)及不明原因(SUE)组相比,微循环灌注改善程度和NIHSS评分差异有统计学意义(P0.05),且无明显不良反应。结论尤瑞克林对LAA患者的疗效明显优于SAO、CE、SOE、SUE患者。

Clinical effectiveness of urinary kallidinogenase on the acute ischemic strokesbased on the TOAST classification

Objective To evaluate clinical effectiveness of urinary kallidinogenase in treatment of acute cerebral infarction (ACI).Methods One hundred and sixty-nine patients with ACI were intravenously infused urinary kallidinogenase (0.15 U/d) for 14 days besides the routine treatment.Cerebral blood flow (CBF),cerebral blood volume (CBV)and time to peak (TTP)were carried out on CTP image before and after the treatment,as well as the NIHSS score,thus to evaluate the clinical effectiveness. Color Doppler ultrasound of carotid artery,vertebral artery and heart,electrocardiogram,dynamic cranial and cervical MRI/MRA were done.Blood routine,blood biochemistries (glucose,lipid,liver and kidney function,myocardial enzymes)and coagulation rou-tine were detected.Results CBF and CBV decreased,TTP delayed in LAA group compared with SAO,CE,SOE,SUE.The NIHSS values were lower in LAA group after having treated with the urinary kallidinogenase (P <0.05).The patients had no sig-nificant adverse drug reaction.Conclusion The treatment of urinary kallidinogenase for the acute ischemic cerebral infarction had better efficacy in LAA than that in SAO and CE.