尤瑞克林对不同结构性影像类型进展性脑梗死的近期效果观察

摘要

Objective To investigate the recent effect of urinary kallidinogenase on acute progressive cerebral infarction in different imagelogy style. Methods 263 patients were divided into four subgroups according to different imagelogy style : large infarct.middle infarct,small infarct and lacunar infarct. These patients were randomly divided into two groups : treatment group with urinary kallidinogenase ( n = 126) and control group ( n = 124 ). According to Chinese guidelines for prevention and management cerebrovascular disease , patients in two groups were treated with basic therapy , such as antiplatelet, neurologic protection , blood pressure control, nerve recovery and so on.Basic treatment strategy of two groups were intravenous injection of Shuxuetong 6ml, Citicoline 0. 5 and Aspirin 0.1 per day for four weeks. Sepcial treatment in treatment group was intravenous injection of urinary kallidinogenase 0. 15 PNAU , and in control group was sodium chloride per day for 7 - 14 days. The primary efficacy was evaluated by NIHSS( the National Institutes of Heahh atroke scale , NIHSS) ,ADL(Activities of daily living , ADL) . Results Our study showed that the scores of NIHSS in four subgroups were higher( P ＜ 0. 01 ) except large infarct( P ＞ 0. 05 ) . The scores of NIHSS in treatment group were higher( P ＜ 0. 01 ) except small infarct( P ＞ 0. 05 ) . The scores in ADL in four suhgroups were higher( P ＜ 0. 01 ) . and the scores of ADL in treatment group were higher( P ＜ 0.01 ) . Concluslon Urinary kallidinogenase is significant effective in the treatment of acute progressive cerebral infarction with different imagelogy style. The scores of NIHSS in lacunar infarct were lower and the scores of ADL were higher.%目的 探讨尤瑞克林对不同结构性影像类型进展性脑梗死的近期效果的差异.方法 按不同结构性影像类型将进展性脑梗死分为大灶梗死、中灶梗死、小灶梗死及腔隙梗死4型,共263例,随机分为尤瑞克林组(治疗组)126例,对照组124例.两组基础用药均为疏血通6ml+生理盐水250ml静脉滴注;胞磷胆碱0.5g+生理盐水250ml静脉滴注;阿司匹林0.1g口服,以上用药均为每天1次,连用4周.治疗组同时给予生理盐水100ml+尤瑞克林0.15PNAu静脉滴注, 对照组同时给予生理盐水100ml静脉滴注,每日1次,连用7～14天,两组治疗前后均评定神经功能缺损程度(NIHSS)、日常生活活动能力(ADL量表).结果 NIHSS评分:治疗后各亚型自身前后对比,除大灶梗死对照组治疗前后没有显著性变化外(P＞0.05),其余各组治疗前后均有显著改善(P<0.01);各亚组中的治疗组与对照组治疗后比较,除小梗死组无显著性差异外(P＞0 05),其余各组治疗前后均有显著差异(P<0.01).ADL评分:治疗后各亚型自身前后对比,均有显著改善(P<0.01);各亚组中的治疗组与对照组治疗后比较,均有显著差异(P<0.01).结论 尤瑞克林对不同结构性影像类型进展性脑梗死各亚型均有显著治疗作用,其中以降低腔隙性梗死组的NIHSS,提高腔隙性梗死组的ADL效果最好.