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目的:探讨急性脑梗死患者血清血小板衍生内皮细胞生长因子(PD-ECGF)的动态变化和醒脑静注射液的干预作用。方法:63例急性脑梗死患者随机分为醒脑静注射液治疗组32例和常规治疗对照组31例,另设立健康对照组60组。两组急性脑梗死患者均给予常规的抗血小板、他汀类药物治疗,治疗组在此基础上加用醒脑静注射液每天20 mL静滴,14 d为1个疗程。采用双抗体夹心酶联免疫吸附法(ELISA)动态测定63例急性脑梗死患者在发病后第1、3、7、14 d时血清PD-ECGF浓度,同时记录63例急性脑梗死患者入院时和治疗14 d后的梗死灶体积,并在治疗前和治疗后14 d后进行美国国立卫生院神经功能缺损评分(NIHSS评分)。结果:和健康对照组比较,63例急性脑梗死患者在中风后1、3、7、14 d各时间点的血清PD-ECGF浓度均明显增高,差异有统计学意义(P<0.05),急性期脑梗死患者的PD-ECGF浓度在中风后3 d达高峰,在中风后14 d维持增高;加用醒脑静注射液干预的治疗组血清PD-ECGF浓度在中风后第3、7、14 d明显高于常规治疗的对照组,差异有统计学意义(P<0.05);应用醒脑静注射液干预治疗14 d后,治疗组平均梗死灶体积小于常规治疗对照组,差异有统计学意义(P<0.05),14 d后治疗组NIHSS评分虽优于对照组,但两组差异未达统计学意义(P>0.05)。结论:急性脑梗死后血清PD-ECGF浓度有动态增高,醒脑静注射液能促进PD-ECGF的产生,参与新生血管形成,有望提高临床疗效。
Objective: To investigate the dynamic changes of serum platelet-derived endothelial cell growth factor (PD-ECGF) and the effect of xingnaojing injection in patients with acute cerebral infarction. Methods: Sixty-three patients with acute cerebral infarction were randomly divided into Xingnaojing injection treatment group (n = 32) and conventional treatment control group (n = 31). Another 60 healthy control subjects were established. The two groups of patients with acute cerebral infarction were given conventional anti-platelet, statin therapy, the treatment group on this basis plus Xingnaojing injection 20 ml intravenous infusion, 14 d for a course of treatment. The serum concentration of PD-ECGF in 63 acute cerebral infarction patients at the 1st, 3rd, 7th, 14th and 14th day after onset was measured dynamically by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). At the same time, 63 patients with acute cerebral infarction The volume of infarction after 14 days of treatment was assessed by National Institutes of Health neurological deficit score (NIHSS score) before treatment and after 14 days. Results: Compared with healthy control group, serum PD-ECGF concentrations in 63 patients with acute cerebral infarction at 1, 3, 7, 14 d after stroke were significantly higher than those in healthy control group (P <0.05) The concentration of PD-ECGF in patients with cerebral infarction peaked on the third day after stroke and remained high on the 14th day after stroke. The concentration of PD-ECGF in the treatment group treated with Xinnaojing injection increased at the 3rd, 7th, 14th d was significantly higher than that of the routine treatment group (P <0.05). After the treatment of Xingnaojing injection for 14 days, the average volume of infarction in the treatment group was smaller than that of the routine treatment control group, the difference was statistically significant (P <0.05). After 14 days, the NIHSS score of the treatment group was superior to that of the control group, but the differences between the two groups did not reach statistical significance (P> 0.05). CONCLUSION: The concentration of PD-ECGF in serum increases dynamically after acute cerebral infarction. Xingnaojing injection can promote the production of PD-ECGF and participate in angiogenesis, which is expected to improve the clinical efficacy.