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目的观察乌司他汀对出血性脑梗死患者的临床疗效及其对基质金属蛋白酶9(MMP-9)和神经元特异性烯醇化酶(NSE)水平的影响。方法 120例出血性脑梗死患者随机分为试验组和对照组,每组60例。对照组给予常规基础治疗,试验组在此基础上加用乌司他汀10万U治疗。2组均治疗14 d。比较2组患者神经功能缺损评分(NIHSS)、日常生活能力(ADL)评分、MMP-9和NSE水平。结果治疗后3 d,试验组NIHSS为(12.42±4.11)分,对照组NIHSS为(16.81±4.32)分;试验组ADL为(36.92±4.10)分,对照组ADL为(32.03±3.39)分;治疗后7 d,试验组NIHSS为(8.82±3.00)分,对照组NIHSS为(13.11±3.31)分;试验组ADL为(48.13±5.42)分,对照组ADL为(38.50±4.79)分,差异有统计学意义(P<0.01)。治疗后3 d,试验组MMP-9为(120.12±11.61)μg·mL~(-1),对照组MMP-9为(136.41±13.52)μg·mL~(-1);试验组NSE为(9.32±1.10),μg·L~(-1),对照组NSE为(12.22±1.51)μg·L~(-1)。治疗后7 d,试验组MMP-9为(99.32±8.83)μg·mL~(-1),对照组MMP-9为(118.71±10.23)μg·mL~(-1);试验组NSE水平为(6.73±0.91)μg·L~(-1),对照组NSE为(9.12±1.10)μg·L~(-1),差异有统计学意义(P<0.01)。药物不良反应主要表现为头晕和恶心,试验组药物不良反应发生率为3.33%(2/60例),对照组为1.67%(1/60例),差异无统计学意义(P>0.05)。结论乌司他汀可以抑制出血性脑梗死患者MMP-9和NSE表达,改善出血性脑梗死患者预后。
Objective To observe the clinical efficacy of ulinastatin in patients with hemorrhagic cerebral infarction and its effect on the levels of matrix metalloproteinase 9 (MMP-9) and neuron-specific enolase (NSE). Methods 120 patients with hemorrhagic cerebral infarction were randomly divided into experimental group and control group, 60 cases in each group. The control group was given routine basic treatment, and the experimental group was treated with ulinastatin 100 000 U on the basis of this. Both groups were treated for 14 days. Neurological deficit scores (NIHSS), ADL scores, MMP-9 and NSE levels were compared between the two groups. Results The NIHSS in the experimental group was (12.42 ± 4.11) d and the NIHSS in the control group was (16.81 ± 4.32) d after the third day of treatment. The ADL in the experimental group was (36.92 ± 4.10) and the control group was (32.03 ± 3.39) The NIHSS in the experimental group was (8.82 ± 3.00) at 7 days after treatment, and the NIHSS in the control group was (13.11 ± 3.31) points. The ADL in the experimental group was (48.13 ± 5.42) points and that in the control group was (38.50 ± 4.79) points, There was statistical significance (P <0.01). The level of MMP-9 in the test group was (120.12 ± 11.61) μg · mL -1 at 3 d after treatment, and (136.41 ± 13.52) μg · mL -1 in the control group. The NSE in the test group was ( 9.32 ± 1.10), μg · L -1, while the control group NSE was (12.22 ± 1.51) μg · L -1. The level of MMP-9 in the experimental group was (99.32 ± 8.83) μg · mL -1 at 7 d after treatment, and (118.71 ± 10.23) μg · mL -1 in the control group. The NSE level in the experimental group was (6.73 ± 0.91) μg · L -1 in the control group, and (9.12 ± 1.10) μg · L -1 in the control group (P <0.01). Adverse drug reactions were mainly manifested as dizziness and nausea. The incidence of adverse drug reactions was 3.33% (2/60 cases) in the test group and 1.67% (1/60 cases) in the control group, with no significant difference (P> 0.05). Conclusion Ulinastatin can inhibit the expression of MMP-9 and NSE in patients with hemorrhagic cerebral infarction and improve the prognosis of patients with hemorrhagic cerebral infarction.