巴曲酶对短暂性脑缺血发作患者血浆Fib、PGF1α及NSE动态影响

摘要

目的 探讨巴曲酶对短暂性脑缺血发作( TIA)患者纤维蛋白原(Fib)、前列腺素1α( PGF1α)和特异性神经元烯醇化酶(NSE)的动态影响. 方法 选择120例发病24h之内颈内动脉系TIA患者,以发作持续时间和次数,分为轻症组和重症组.以是否使用巴曲酶治疗分为治疗组和常规组,并于发病第1、3、7、14天测血浆Fib、PGF1α和NSE水平,同时比较其疗效. 结果 TIA发生后即出现NSE水平升高,第3天升高更明显,至第7天起呈下降趋势,至第14天进一步下降.Fib则于第3天降至最低,后逐步回升.巴曲酶治疗组NSE、Fib水平较常规治疗组水平降低,轻症组NSE低于重症组(P＜0.05).TIA组PGF1α水平于发病后第3天开始升高,第7、14天继续升高(P＜0.05).重症组PGF1α水平低于轻症组(均P＜0.05)；常规治疗组低于巴曲酶治疗组(均P＜0.05).巴曲酶治疗组总有效率高于常规治疗组,轻症组有效率高于重症组(P＜0.05). 结论 巴曲酶可降低颈内动脉系TIA患者血浆NSE、Fib水平,升高血浆PGF1α水平,而上述变化能反映病情及愈后.%Objective To investigate the dynamic effect of batroxobin on the plasma levels of fibrinogen( Fib) .prostaghndin F1α(PGF1α) and neuron-specific enolase(NSE) in patients with transient ischemic attacks(TIA). Methods 120 cases of T1A(<24 h from onset) were divided into the mild group and severe group according to the attack duration and times. Each group was further divided into two groups, one group receiving routine treatment and another group receiving batroxobin treatment. The levels of NSE, Fib,and PGF1α were measured on 24 h, 3 d, 7 d and 14 d, and then the curative effects were analyzed. Results 24 h after the onset of TIA, the levels of NSE increased, and the increase became more obviously on 3rd day; till 7th day, the levels started to decline(P <0.05) ;The level of PGF1α started to increase on 3rd day, and become more obviously on 7th day and 14th day(P <0. 05). The lowest level of Fib occurred on 3rd day,then the level of Fib started to rise. The curative rate of the group treated with batroxobin (79. 00% ) was higher than that of the group receiving routine treatment (25.00% ) and the curative rate of mild group was higher than that of severe group (P < 0.05). The levels of NSE, Fib were lower and the level of PGF1α was higher in the group treated with batroxobin than those in the group receiving routine treatment. The levels of NSE, Fib were lower (P <0. 05) and the level of PGF1α was higher in mild group than those in severe group. Conclusions Batroxohin treatment for patients with T1A is more effective according to the changes of the level of NSE, Fib,and PGF1α. It reflects the state and prognosis of the illness.