降纤药、抗栓药治疗急性脑梗死的临床疗效和血浆生物分子变化对比研究

将134例急性脑梗死患者分为三组，分别给予低分子肝素钠，藻酸双酯钠（PSS）和降纤酶治疗，观察其临床疗效，以及血脂，血糖，凝血功能，纤维蛋白原（Fbg)和血浆内皮素－1（ET－1）－P－选择素（P-selec)，血管内皮生长因子（VEGF）和血小板活化因子（PAF）的浓度变化。结果显示，治疗后三组临床疗效经Ridit分析无显著差异，三种药物对血生化指标和血浆生物分子浓度的影响有显著差异，表现为低分子肝素钠对血脂，血糖无影响，有明显抗凝和降低Fbg作用，对PAF有抑制作用，PSS有降低血脂，血糖，明显的抗凝及降低Fbg作用，对血浆生物分子中的ET－1，P-selec和PAF有抑制作用；降纤酶对血脂，血糖无影响有明显抗凝和降低Fbg作用，对ET－1，P-selec和PAF有抑制作用，可提高VEGF的血浆浓度。认为这三种药物的共同作用机理是抗凝，不同点是PSS和降纤酶对脑缺血后产生的一系列生物活性物质有抑制作用，特别是VEGF变化可能是给缺血性脑血管病的治疗带来新的认识。

Anti-fibrinogens and anti-coagulations medicines on acute cerebral infarction

patients with acute cerebral infarction(ACI) were divided into 3 groups and treated by the low dose heparin,polysaccharidesulfate(PSS) and defibrinogenase respectively.It was observed that the clinical effect,the changes of blood lipids and blood glucose,blood coagulation function,fibrinogens and the plasm concentration of the endothelin-1(ET-1),P-selec,vessel endothelin growth factor(VEGF) and platelet activating factor(PAF) before and after treatment.Results showed that the clinical effect has no difference among 3 groups,but the blood biochemicals items and plasm biomoleculs levels had significant difference among 3 groups.The blood lipids and glucose had no change,the Fbg was decreased,the plasm PAF was depressed in the low dose heparin group.The blood lipids and blood glucose and Fbg were decreased,the ET-1,P-selec and PAF were depressed in the PSS group.The blood lipids and glucose had no change,the Fbg was decreased,the ET-1,P-selec and PAF were depressed,the plasm VEGF levels was raised in the defibrinogenase group.These suggest that the characteristic of 3 medicines are anticoagulations effective,and the difference points are PSS and defibrinogenase could depress the serious harms matters after ischemic stroke onset.The change of plasm VEGF may be brought a new viewpoint for treatment of ischemic cerebral vascular disorder.