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为探讨人尿激肽原酶对非心源性缺血性脑卒中(ischemic stroke,IS)的疗效及其对免疫功能的影响,本研究以2013年2月至2016年3月期间重庆市第六人民医院诊治的82例非心源性IS患者为研究对象,依据治疗方法的不同将患者分为对照组(常规基础治疗组)和观察组(常规基础治疗+人尿激肽原酶组),每组各41例。分别利用美国国立卫生研究院脑卒中量表(national institutes of health stroke scale,NIHSS)、Barthel指数和长谷川简易智能量表(Hasegawa dementia scale,HDS)评估两组患者的临床治疗效果,同时采用速率散射免疫比浊法和流式细胞术检测免疫相关指标。研究结果显示,治疗后两组患者的NIHSS评分均明显降低,而Barthel指数和HDS评分则显著升高(P<0.05);观察组患者的NIHSS得分明显低于单独组,Barthel指数和HDS评分则显著高于对照组,差异均具有统计学意义(P<0.05);治疗后,两组患者CD4+T细胞(%)、CD4+T细胞/CD8+T细胞和Treg/CD4+T细胞的水平显著增加,而CD8+T细胞(%)、Th1细胞、Th2细胞百分比、Th1细胞/Th2细胞和Th17细胞/CD4+T细胞的水平明显降低(P<0.05);观察组患者上述指标的改善幅度均明显优于对照组,差异均具有统计学意义(P<0.05);两组患者CD3+T细胞(%)、IgA、IgM、IgG、补体C3和C4等水平之间的比较均无显著差异(P>0.05)。综上,本研究发现人尿激肽原酶可显著改善非心源性IS患者的神经缺损功能,促进T细胞相关免疫功能的恢复,但对体液免疫功能影响较小。
In order to investigate the therapeutic effect of human urokinase on non-cardiac ischemic stroke (IS) and its effect on immune function, this study was conducted in Chongqing from February 2013 to March 2016 Sixty-two People’s Hospital diagnosis and treatment of 82 non-cardiac IS patients as study subjects, according to the different treatment methods will be divided into control group (conventional basic treatment group) and observation group (conventional basic treatment + human kallikrein group) , 41 cases in each group. The clinical outcomes of the two groups were evaluated using the National Institutes of Health Stroke Scale (NIHSS), Barthel Index, and Hasegawa dementia scale (HDS), respectively, Immunoassay with turbidimetry and flow cytometry were used to detect immune related indicators. The results showed that NIHSS scores decreased significantly in both groups after treatment, but Barthel index and HDS score increased significantly (P <0.05). NIHSS scores in the observation group were significantly lower than those in the control group, Barthel index and HDS score (P <0.05). After treatment, the levels of CD4 + T cells (%), CD4 + T cells / CD8 + T cells and Treg / CD4 + T cells in both groups were significantly higher than those in the control group (P <0.05), while the levels of CD8 + T cells (%), Th1 cells, Th2 cells, Th1 cells / Th2 cells and Th17 cells / CD4 + T cells in the observation group were significantly decreased (P <0.05). There was no significant difference between the two groups in the levels of CD3 + T cells (%), IgA, IgM, IgG, C3 and C4 (P> 0.05). In summary, the present study found that human urokinase can significantly improve the non-cardiac IS patients with neurological deficit function and promote the recovery of T cell-related immune function, but less on humoral immune function.