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1、降纖酶治療急性腦梗塞的臨床研究來源:中華現(xiàn)代臨床醫(yī)學(xué)雜志作者:袁建新黃燕冰高文靜2005-9-22摘要:【摘要】目的通過人樣本、隨機(jī)、對照的臨床研究,對降纖酶治療急性腦梗塞的有效性及安全性進(jìn)行客觀評價。方法將在48h之【文章編號】1726?7587(2004)10-1636-04ClinicalstudyoneffectsofdefibraseonacutecerebralinfarctionYuanJianxin,HuangYanbing,GaoWenjingDepartmentofNeurology,KailuanHospital,Tangshan063000.[Abstract]O
2、bjectiveToassessthesafetyandefficacyofdefibraseinthetreatmentofacutecerebralinfarctionbyalargesample,randomizedandcontrolledclinicaltrial.Methods654patientssufferedacutecerebralinfarctionwithin48hourswererandomlydividedinto2groups:defibrasegroupandcontrolgroup.EachpatientinthedefVbrasegroupwastre
3、atedwithdefibraseoflOuforthefirstthreedaysand5ufortherestsevendays,whilethoseinthecontrolgroupweregiventheMaiLuoNing20ml/dxlO.TheendpointsincludedClinicallyNeurologicalDeficitsScaleofStroke,thelevelofplasmaFIB,D-D,PLG,tPA,PAIandrateofprogressivestroke.ResultsNotonlyhastheNeurologicalDeficitsScale
4、ofStrokeofdefibrasegroupdecreasedsignificantlycomparedwithcontrolgroup(P<0.01),butalsotherateofprogressivestrokeindefibrasegroupwaslowerthanthatincontrolgroup(P<0.05)whendefibrasewasusedwithin24hours.ThelevelofplasmaFIBinthepatientsofdefibrasegroupwassignificantlyde"creasedcomparedwiththato
5、fthecontrolgroup(P<O.Ol)?ThelevelofplasmaD-D,tPAwashigherbutthelevelofplasmaPLGwaslowerthanthatofthecontrolgroupaftcr24,48hours(P<0.01)whereasthebleedingeventsandotheradvcrscsreactionwerenotincreasedascomparedwiththecontrolgroup.ConclusionDefibrasetreatmentcoulddecreasethelevelofplasmaFIBsi
6、gnificantlyandenhancetPAactivity.Defibrasetreatmentisasafeandeffectiveapproachforacutecerebralinfarction.KeywordsacutecerebralinfarctiondefibrasefibrinogentPAactivity目絕大對急性腦梗塞進(jìn)行溶栓治療雖然取得了定的效果,但仍冇一些問題尚未解決(:1)患者不能夠在發(fā)病后6h內(nèi)就醫(yī)。(2)溶栓后易發(fā)生急性再梗塞。(3)并發(fā)顱內(nèi)狀況,治療效果差、死亡率高。(4)対進(jìn)展型腦梗塞的岀血達(dá)5%?10%,—旦發(fā)生研究迄今未了足夠的重視。因此,
7、選擇較理想的藥物及合理的川藥方法治療急性腦梗塞仍然是目而的主要問題。降纖酶貝有溶栓、抑栓及活血化瘀的作用,筆者于1999年12月?2003年12刀較系統(tǒng)的觀察了降纖酶對急性腦梗塞的治療作用及對纖溶活性和纖維蛋白原的影響,對降纖酶治療急性腦梗塞的有效性及安全性進(jìn)行客觀評價。1臨床資料L1病例入選標(biāo)準(zhǔn)(1)首次發(fā)病或有卒屮史但未留后遺癥者;(2)臨床表現(xiàn)為頸動脈系統(tǒng)卒屮綜合征;(2)發(fā)病時間<48h,符合1995年全國第四屆腦血管