降纤酶治疗急性脑梗死的临床探讨

目的 :探讨降纤酶治疗急性脑梗死的临床最佳剂量和疗效。方法 :将脑梗死患者按入院顺序分成四组 ,每组使用降纤酶静脉滴注总剂量相同 ,但每天剂量不同 ,大剂量组 2 0u/d× 3天 ,中剂量组 15u/d× 4天 ,小剂量组 10u/d× 6天 ,三组均进行基础治疗 ,用药同对照组 ,对照组用低分子右旋糖酐 5 0 0ml、脑复康 10～ 12g共 2 0天。结果 :四组的疗效差异有显著性 (P <0 .0 0 5 ) ,大剂量组有效率 79.4 % ,中剂量组 85 .5 % ,小剂量组 5 6 .9% ,对照组 5 6 .1% ,而且神经功能缺损评分中剂量组均优于其余 3组 (P <0 .0 1) ,纤维蛋白原的下降程度亦是中剂量组效果明显 (P <0 .0 5～P <0 .0 1)。结论 :降纤酶治疗急性脑梗死 ,使用中等剂量每天 15u总量 6 0u不导致出血 ,不但方法简便 ,经济实用 ,而且安全有效 ,是基层医院能普及的有效治疗方案。

Clinical study of defibrase therapy for acute cerebral infarction

Objective:To investigate the optimal dosage of defibrase in treating acute cerebral infarction.Methods:The patients suffering from acute cerebral infarction were divided into four groups in the sequence of admission to the hospital:large dose group(defibrase 20 u intravenous drip every day for 3 days),moderate dose group(defibrase 15 u intravenous drip every day for 4 days),low dose group(defibrase 10 u intravenous drip every day up to 6 days),and control group(no defibrase therapy).The therapy for all groups was Dextra 40 500ml and piracetami 10 to 12 g intravenous drip daily for 20 days.Results:The curative effects were significantly different among the groups( P <0.005).The effective rates of the four groups were 79.4%, 85.5 %,56.9% and 56.1%,respectively.Neurological functional deflect scales(NFDS) in the moderate dose group were the best( P <0.01).The decreasing of serum fibrogen in the moderate dose group was the most obvious,too( P <0.05 to P <0.01).Conclusions:The moderate dose of defibrase is quick,safe and economical in the treatment of acute cerebral infarction.