巴曲酶联合低分子肝素治疗急性进展性脑梗死40例疗效观察

目的：观察巴曲酶与低分子肝素联合治疗急性进展性脑梗死的临床疗效及安全性。方法：120例急性进展性脑梗死病例随机分为巴曲酶组、低分子肝素组、巴曲酶联合低分子肝素治疗组（联合治疗组）。巴曲酶组患者给予巴曲酶10BU静脉滴注每日1次，连用3d；低分子肝素组给予低分子肝素5000U皮下注射，每日2次，连用10d；联合治疗组给予巴曲酶10BU静脉滴注每日1次，连用3d，及低分子肝素5000U皮下注射，每日2次，连用10d。于治疗前、治疗后7d，14d时进行神经功能缺损程度评分（NDS），在治疗前、治疗后10d进行凝血指标检测。结果：联合治疗组总有效率（97．5％）明显高于巴曲酶组（77．5％）与低分子肝素组（70％）（均P〈0．05）。各组治疗前后凝血酶原时间、活化部分凝血酶时间、凝血酶时间差异均无统计学意义。联合治疗组和巴曲酶组经治疗，血浆蛋白原含量比治疗前显著降低（均P〈0．01）。联合治疗组5例，巴曲酶组1例，低分子肝素组2例出现轻微皮下、牙龈出血，无其他不良反应。结论：巴曲酶与低分子肝素联合治疗急性进展性脑梗死的疗效较好，优于单独使用巴曲酶或低分子肝素，且无明显不良反应。

Curative effects observataion of batroxobin combined with low molecular eight heparin on treating acute progressive cerebral infarction

Objective: To observe the effect of batroxobin combined low molecular weight heparin on treating acute progressive cerebral infarction.Methods: 120 patients with acute developed ischemic attack were randomly divided into three groups: batroxobin therapy group,low molecular weight heparin therapy group,batroxobin plus low molecular weight heparin therapy group(combined therapy group).Batroxobin therapy group was treated with batroxobin 10BU iv drip,once a day for three days.Low-weight heparin therapy group was treated with low molecular weight heparin 5000 U iH Bid for ten days.The combined group was treated with batroxobin 10BU iv drip Qd for three days and low molecular weight heparin 5000 U iH Bid for ten days.Neurological deficit scores were examined before treatment,and 7days and 14 days after treatmen.PT,APTT,TT,Fib were examined before treatment and at 10days after treatment.Results: The tolal effective rate(97.5%) of the combined therapy group was significantly higher than that of batroxobin group(77.5%) and low molecular weight heparin group(70.0%)(P<0.05).After treatment,there was no significant difference in PT,APTT,TT among three group compared with that before treatment.The levels of plasma fibrinogen were significantly decreased in combined therapy group and batroxobin therapy group(P<0.05).There was no serious adverse reaction in three groups.Conclusion: Batroxobin combined low molecular weight heparin are effective and safe in the therapy on acute cerebral infraction.