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目的 观察降纤酶治疗急性脑梗死的效果。 方法 降纤酶与安慰剂治疗进行了随机双盲对照研究。 结果 治疗组第 1 4天神经功能缺损程度的评分低于对照组 ,P <0 .0 5 ,有显著性差异。两组出院时与 1 2周患者日常生活能力 ,即 Barthel指数计分比较 :对照组出院时与 1 2周相比 ,P <0 .0 5 ,有显著性差异 ;治疗组出院时与 1 2周相比 ,P <0 .0 1 ,有显著性差异 ;对照组与治疗组二者相比 ,P <0 .0 5 ,亦有显著性差异 ,表明治疗组患者日常生活能力的改善优于对照组。纤维蛋白原含量动态观察表明 :用药前和第 2天相比变化不大 ,P >0 .0 5 ;第 4天纤维蛋白原开始下降 ,P <0 .0 5 ;第 6天维持在第 4天水平 ,第 4天和第 6天相比 ,P >0 .0 5。通过对用药前后谷丙转氨酶 ( GPT)和尿素氮 ( BUN)的动态观察表明 ,降纤酶对 GPT有降低趋势 ,对 BUN无任何影响 ,本组全部病例均未见全身出血倾向或致颅内出血之并发症发生。治疗组死亡 1例 ,死亡原因系心房纤颤 ,急性肺水肿引起的呼吸循环衰竭 ,死亡前患者神经系统症状体征无变化 ,与应用降纤酶无关。 结论 降纤酶有明显降低纤维蛋白原 ,改善微循环的作用 ,对肝肾无害 ,也未见其它并发症。由于它纯度高及特异性的与血栓表面的纤维蛋白原结合 ,因此 ,避免了尿激酶、链激酶
Objective To observe the effect of defibrase on acute cerebral infarction. Methods A definitive, double-blind, controlled study of defibrase and placebo treatment. Results The score of neurological deficit in the 14th day in the treatment group was lower than that in the control group (P <0.05). There was a significant difference. Compared with the Barthel index, the control group had a significant difference in the daily living ability at 12 weeks after discharge between the two groups (P <0.05) P <0. 01, there was a significant difference between the control group and the treatment group, P <0. 05, there are significant differences, indicating that the improvement of daily living ability of patients in the treatment group is superior to Control group. Dynamic observation of the content of fibrinogen showed that there was no significant change before treatment compared with that on the second day (P> 0.05); fibrinogen began to decrease on the 4th day (P <0.05), and remained on the 4th day Day level, day 4 and day 6, P> 0.05. The dynamic observation of GPT and BUN before and after treatment showed that defibrase decreased the GPT but had no effect on BUN. No bleeding tendency or intracranial hemorrhage was found in all cases The complications occurred. In the treatment group, 1 patient died, the cause of death was atrial fibrillation and respiratory failure due to acute pulmonary edema. No change was found in the symptoms and signs of nervous system before death, which was not related to the application of defibrase. Conclusion defibrase has significantly reduced fibrinogen, improve microcirculation, harmless to the liver and kidney, and no other complications. Because of its high purity and specificity of thrombus surface fibrinogen, therefore, to avoid the urokinase, streptokinase