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目的:客观评价东菱克栓酶与纤溶酶治疗脑梗死(发病6～72小时内)的临床郊效及对血液流变学指标的对比分析。方法:本研究为一随机对照临床研究。凡符合入选标准的病人随机分为2组:治疗组40例,东菱克栓酶首次剂量10Bu加生理盐水250ml静点,第3天、第5天各用东菱克栓酶5BU加于生理盐水250ml静点,共3次;对照组40例,纤溶酶首次剂量100BU加生理盐水500ml静点,第2天以后200BU加生理盐水500ml静点,每天1次,共7天。其他治疗方法2组相同。治疗前后观察临床疗效、神经功能缺损评分以及血液流变学的变化。结果:东菱克栓酶治疗组总显效率为67.50%,总有效率为92.50%,与对照比较差异有显著性(P<0.05),治疗后神经功能缺损评分显著降低,与对照组比较差异具有非常显著性(P<0.01)。治疗组治疗前后血液流变性改变具有非常显著性差异(P<0.01),对照组治疗前后具有显著性差异(P<0.05),治疗组较对照组治疗前后血液流变学改善明显,两组间差异有显著性(P<0.05),其中纤维蛋白原差异非常显著性(P<0.01)。两组治疗期间均未发现明显的不良反应。结论:东菱克栓酶治疗急性脑梗死(发病6～72小时内)主要作用是降低纤维蛋白原含量,促进血栓溶解,改善微循环及血液流变学指标显著,具有疗效好,安全性高等优点。
OBJECTIVE: To objectively evaluate the clinical sub-clinical effect and the comparative analysis of hemorheological indexes of Batroxobin and plasmin in the treatment of cerebral infarction (within 6 to 72 hours of onset). Methods: This study was a randomized controlled clinical study. All eligible patients were randomly divided into two groups: the treatment group 40 cases, the first dose of Bromhide embolization 10Bu plus normal saline 250ml static point, the first three days, the first five days of each Ling bolt with carboplatin 5BU added to the physiology Saline 250ml static point, a total of 3 times; control group of 40 cases, plasmin first dose of 100BU plus saline 500ml static point, the second day after 200BU plus normal saline 500ml static point, day 1, a total of 7 days. Other treatments are the same in both groups. Before and after treatment, clinical efficacy, neurological deficit score and hemorheology were observed. Results: The total effective rate was 67.50%, the total effective rate was 92.50%, and the difference was significant compared with the control (P <0.05), the score of neurological deficit after treatment was significantly lower than that of the control group It has very significant (P <0.01). The hemorrheological changes of the treatment group before and after treatment had very significant difference (P <0.01), the control group had significant difference before and after treatment (P <0.05), the treatment group than the control group before and after treatment, hemorheology improved significantly, between the two groups The difference was significant (P <0.05), among which the difference of fibrinogen was very significant (P <0.01). No significant adverse reactions were found during the two groups. Conclusion: The treatment of acute cerebral infarction with rhubarb thrombin (within 6 to 72 hours of onset) is to reduce the content of fibrinogen, promote thrombolysis, improve microcirculation and hemorheology indexes, with good curative effect and high safety advantage.