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目的探讨人尿激肽原酶治疗急性缺血性脑卒中的效果,为急性缺血性脑卒中的治疗提供依据。方法选取2011年12月~2013年12月辽宁省盘锦市中心医院收治的急性缺血性脑卒中患者120例作为研究对象,分为两组,各60例。对照组根据病情合理选用甘露醇脱水降颅压、阿司匹林抗血小板聚集、防治并发症、必要的营养支持和康复治疗等常规治疗;治疗组在此基础上用人尿激肽原酶0.15 PNAu加入生理盐水250 m L中静脉滴注,每天1次,连用14 d。观察两组患者治疗效果、治疗前后神经功能缺损评分(NIHSS),以及治疗后日常生活能力情况、复发及不良反应情况。结果治疗组基本治愈17例,显著进步31例,进步10例,无效2例,恶化0例,总有效率为96.67%;对照组基本治愈12例,显著进步21例,进步8例,无效16例,恶化3例,总有效率为68.33%;两组总有效率相比,差异有统计学意义(P<0.05);治疗组治疗14 d后NIHSS评分[(7.06±3.64)分]显著优于治疗前[(15.03±5.77)分]和对照组治疗后[(9.85±4.35)分],差异均有统计学意义(P<0.05);治疗组治疗后日常生活活动能力评分[(58.4±5.6)分]显著优于治疗前[(38.7±6.3)分]和对照组治疗后[(43.3±5.4)分],差异均有统计学意义(P<0.05);治疗组治疗14 d后hs-CRP水平[(2.13±0.30)mol/L]显著低于治疗前[(6.73±0.78)mol/L]和对照组治疗后[(3.73±0.43)mol/L],差异有统计学意义(P<0.05);两组患者治疗期间均无严重不良反应发生。结论应用人尿激肽原酶能够显著改善急性缺血性脑卒中患者神经功能缺损程度,提高患者后期的生活能力,降低血清hs-CRP水平,减轻炎性反应,有良好的临床疗效,值得临床推广应用。
Objective To investigate the effect of human urokinase on acute ischemic stroke and provide basis for the treatment of acute ischemic stroke. Methods A total of 120 patients with acute ischemic stroke who were admitted to Panjin Central Hospital of Liaoning Province from December 2011 to December 2013 were selected as study subjects and divided into two groups of 60 patients each. In the control group, mannitol dehydration was used to reduce intracranial pressure, anti-platelet aggregation of aspirin, prevention and treatment of complications, necessary nutrition support and rehabilitation treatment according to the condition. The treatment group was treated with human urine kininogenase 0.15 PNAu 250 m L infusion, 1 day, once every 14 d. The therapeutic effect, the neurological deficit score (NIHSS) before and after treatment, as well as the daily living ability, recurrence and adverse reactions after treatment were observed. Results In the treatment group, 17 cases were basically cured, 31 cases were significantly improved, 10 cases were improved, 2 cases were ineffective, 0 cases were deteriorated, and the total effective rate was 96.67%. In the control group, 12 cases were cured basically, 21 cases were significantly improved, 8 cases improved and 16 cases were ineffective The total effective rate was 68.33% in 3 cases, the difference was statistically significant (P <0.05). The NIHSS score [(7.06 ± 3.64) points after treatment for 14 days in treatment group was significantly superior (15.03 ± 5.77) before treatment and (9.85 ± 4.35) minutes after treatment in the control group (P <0.05). The scores of activities of daily living in the treatment group after treatment [(58.4 ± 5.63) was significantly better than that before treatment (38.7 ± 6.3) and control group (43.3 ± 5.4) after treatment, the differences were statistically significant (P0.05) (2.13 ± 0.30) mol / L] were significantly lower than those before treatment [(6.73 ± 0.78) mol / L] and [3.73 ± 0.43] mol / L after treatment in the control group P <0.05). No serious adverse reactions occurred in both groups during the treatment. Conclusion The application of human urine kallikrein can significantly improve the degree of neurological deficits in patients with acute ischemic stroke, improve patients’ later life expectancy, reduce serum hs-CRP level, reduce inflammatory reaction, and have good clinical efficacy, which is worth clinical Promote the application.