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目的观察血栓通注射液与阿司匹林治疗急性复发性脑梗死的临床疗效及其对血管内皮生长因子(VEGF)血清水平的影响。方法 80例急性复发性脑梗死患者分为试验组40例与对照组40例。在常规治疗的基础上,对照组给予阿司匹林100 mg pid,口服;试验组在对照组的基础上给予血栓通注射液500mg,每天1次,静脉滴注,2组均连续治疗14 d。观察2组患者的临床疗效,比较2组患者的血流动力学指标变化情况、血栓调节蛋白(TM)、组织纤溶酶原激活物抑制物(PAI)、组织纤溶酶原激活物(t-PA)及D-二聚体(D-dimer)水平及VEGF水平。结果治疗后,试验组总有效率为92.50%(37/40例),对照组为82.50%(33/40例,P>0.05)。治疗后,试验组患者全血高切黏度(5.45±0.78)mPa·s,血浆高切黏度(1.87±1.33)mPa·s,对照组全血高切黏度为(5.91±0.24)mPa·s,血浆高切黏度为(2.20±3.09)mPa·s,差异有统计学意义(P<0.05)。治疗后,试验组TM为(35.36±8.14)ng·mL~(-1),PAI为(0.73±0.30)AU·mL~(-1),t-PA为(1.97±0.18)U·mL~(-1),D-二聚体为(0.42±0.28)mg·L~(-1);对照组TM为(39.50±10.25)ng·mL~(-1),t-PA为(1.35±0.14)U·mL~(-1),D-二聚体为(0.43±0.24)mg·L~(-1),2组较治疗前差异有统计学意义(P<0.05)。试验组t-PA与对照组比较,差异有统计学意义(P<0.05)。试验组治疗3,7,14 d的VEGF水平分别为(320.24±45.63),(436.33±35.84),(398.31±46.60)ng·L~(-1),对照组分别为(370.41±39.52),(542.72±68.00),(352.72±49.80)ng·L~(-1),2组差异有统计学意义(P<0.05)。所有患者治疗中均未出现药物不良反应,安全性良好。结论血栓通注射液与阿司匹林治疗急性复发性脑梗死疗效显著,血栓通注射液能够有效改善患者血清VEGF水平。
Objective To observe the clinical efficacy of Xuesaitong Injection and aspirin in the treatment of acute recurrent cerebral infarction and its effect on the serum level of vascular endothelial growth factor (VEGF). Methods 80 patients with acute recurrent cerebral infarction were divided into experimental group (40 cases) and control group (40 cases). On the basis of routine treatment, the control group was given aspirin 100 mg pid orally; the experimental group was given Xueshuantong Injection 500mg on the basis of the control group once a day by intravenous drip, and the two groups were treated continuously for 14 days. The clinical effects of two groups were observed. The changes of hemodynamics, thrombomodulin (TM), tissue plasminogen activator inhibitor (PAI), tissue plasminogen activator (t -PA) and D-dimer (D-dimer) levels and VEGF levels. Results After treatment, the total effective rate was 92.50% (37/40 cases) in the test group and 82.50% (33/40 cases, P> 0.05) in the control group. After treatment, the whole blood viscosity (5.45 ± 0.78) mPa · s and plasma high-shear viscosity (1.87 ± 1.33) mPa · s in the test group and (5.91 ± 0.24) mPa · s in the control group, The plasma high shear viscosity was (2.20 ± 3.09) mPa · s, the difference was statistically significant (P <0.05). After treatment, the levels of t-PA in the test group were (35.36 ± 8.14) ng · mL -1, PAI was (0.73 ± 0.30) AU · mL -1 and t-PA was (1.97 ± 0.18) U · mL ~ (-1), D-dimer was (0.42 ± 0.28) mg · L -1; the control group was (39.50 ± 10.25) ng · mL -1 and t-PA was 1.35 ± 0.14) U · mL -1 and D-dimer was (0.43 ± 0.24) mg · L -1, respectively. There were significant differences between the two groups before treatment (P <0.05). The experimental group t-PA compared with the control group, the difference was statistically significant (P <0.05). The levels of VEGF in the experimental group were (320.24 ± 45.63), (436.33 ± 35.84) and (398.31 ± 46.60) ng · L -1 on the 3rd, 7th and 14th day after treatment, respectively. The control group were (370.41 ± 39.52) (542.72 ± 68.00) and (352.72 ± 49.80) ng · L -1, respectively. There was significant difference between the two groups (P <0.05). All patients treated with no adverse drug reactions, good safety. Conclusion Xueshuantong injection and aspirin treatment of acute recurrent cerebral infarction significant effect, Xueshuantong injection can effectively improve the serum VEGF levels.