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目的 验证降纤酶治疗急性脑梗死的临床疗效及其血液学的改变。 方法 采用病历与对照的方法将病例随机分为两组。降纤酶组 1 42例 (治疗组 ) ,低分子右旋糖酐组 4 0例 (对照组 ) ,治疗前两组纤维蛋白原和神经功能缺损程度评分无差异 ( P >0 .0 5)。 结果 治疗后 3天神经功能缺损程度评分两组比较有差异 ( P <0 .0 5) ,治疗后 1 4天两组有显著性差异 ( P <0 .0 0 1 )。降纤酶治疗急性脑梗死的总有效率为 90 .1 %( 1 2 8/1 42 ) ,而低分子右旋糖酐治疗的总有效率为 62 .5%( 2 5/4 0 )。 结论 治疗后 3天、 7天 ,治疗组和对照组之间纤维蛋白原有显著性差异 ( P <0 .0 0 1 ) ,其升高除引起血浆粘度增高以外 ,还与血栓形成有密切关系 ,且在血小板的粘附和聚集中起桥梁作用。降纤酶治疗后 7天 ,血纤维蛋白原开始回升。
Objective To verify the clinical efficacy of defibrase in the treatment of acute cerebral infarction and its hematological changes. Methods The cases were randomly divided into two groups according to the medical record and the control method. There were no differences in the scores of fibrinogen and neurological deficit between the 42 patients in the defibrase group (treatment group) and 40 in the low molecular dextran group (control group), before treatment (P> 0.05). Results The score of neurological deficit on the 3rd day after treatment was significantly different between the two groups (P <0.05). There was a significant difference between the two groups on the 14th day after treatment (P <0.01). The total effective rate of defibrase in the treatment of acute cerebral infarction was 90.1% (12 8/1 42), while that of low molecular dextran treatment was 62.5% (25/40). Conclusions There was a significant difference in fibrinogen between the treatment group and the control group at 3 and 7 days after treatment (P <0.01). The increase of plasma fibrinogen was not only associated with the increase of plasma viscosity, but also with the thrombosis , And plays a bridging role in platelet adhesion and aggregation. Seven days after defibrase treatment, fibrinogen began to rise.