丁楠,王玉凯,周静,伍国强
DING Nan,WANG Yukai,ZHOU Jing,WU Guoqiang

• 1:佛山市第一人民医院神经内科

摘要(Abstract)：

目的探讨尤瑞克林用于改善前循环急性脑梗死患者侧支循环的临床疗效。方法将2016年3月~2017年3月在某院神经内科治疗的120例初发急性脑梗死患者随机分为对照组及观察组,每组60例,对照组采用常规西医治疗方案,观察组在常规治疗基础上加用尤瑞克林治疗,比较两组患者的治疗效果、脑部血流量改善情况、血清前列环素(PGI2)、一氧化氮(NO)水平及神经功能缺损情况。结果观察组治疗有效率为76.67%、侧支循环开放率为73.33%,对照组治疗有效率为65%、侧支循环开放率为51.67%,差异有统计学意义(P<0.05);观察组患侧大脑前动脉(ACA)、大脑中动脉(MCA)、大脑后动脉(PCA)血流速度明显高于对照组,治疗后脑血流量(CBF)、脑血容量(CBV)、峰值时间(TTP)明显优于对照组,差异有统计学意义(P<0.05);观察组血清PGI2和NO水平较对照组改善不明显,差异无统计学意义(P>0.05);观察组NIHSS评分显著低于对照组,差异有统计学意义(P<0.05)。结论尤瑞克林用于改善前循环急性脑梗死患者侧支循环有显著效果,能有效改善缺血半暗带的血液灌注,减轻脑组织的受损程度,促进神经功能的恢复,具有积极的临床意义。
OBJECTIVE To explore the clinical effects of urinary kallindinogenase on collateral circulation for patients with acute cerebral infarction of anterior circulation.METHODS A total of 120 patients with acute cerebral infarction from March 2016 to March2017 in our hospital were selected and randomly divided into two groups.Control group received conventional therapy while observation group had additional therapy of urinary kallidinogenase.The therapeutic effects,cerebral blood flow,serum prostacyclin(PGI2),nitric oxide(NO) levels,and neurological deficits were compared between the two groups.RESULTS The effective rate was obviously higher in observation group than that in control group(P<0.05),and the opening ratio of collateral circulation was obviously higher in observation group(P<0.05).The blood velocity of ACA,MCA and PCA in the observation group was significantly higher than that in the control group(P<0.05).The cerebral blood flow(CBF),the cerebral blood volume(CBV) and the peak time(TTP) of the observation group were significantly better than those of the control group(P<0.05).The serum PGI2 and NO levels in the observation group were not significantly improved compared with the control group(P>0.05).The scores of NIHSS in the observation group were significantly lower than those in the control group(P<0.05).CONCLUSION Urinary kallidinogenase has significant effects on patients with acute cerebral infarction of anterior circulation.

关键词(KeyWords)： 尤瑞克林;前循环急性脑梗死;侧支循环;临床效果
urinary kallidinogenase;the anterior circulation acute cerebral infarction;collateral circulation;clinical effect

Abstract:

Keywords:

基金项目(Foundation): 佛山市卫生和计生局医学科研课题(2015069)

作者(Author): 丁楠,王玉凯,周静,伍国强
DING Nan,WANG Yukai,ZHOU Jing,WU Guoqiang

参考文献(References)：

• [1]冯玉花.尤瑞克林对前循环急性脑梗死患者侧支循环的改善作用[J].中国实用神经疾病,2016,19(12):77-78.
• [2]潘剑罡,柯俊龙,张惠婷.尤瑞克林对急性前循环脑梗死患者软脑膜侧支循环代偿的作用及疗效观察[J].实用医学杂志,2014,30(11):1809-1810.
• [3]吴晓清,张宝荣.尤瑞克林治疗老年急性前循环脑梗死的近期临床效果及安全性[J].中国老年学杂志,2014,34(6):1474-1475.
• [4]陆婉杏,罗章伟,蒙兰青.尤瑞克林针联合中药对首发急性脑梗死局部脑血流影响[J].辽宁中医药大学学报,2016,18(1):154-156.
• [5]莫俊宁,黄燕.脑侧支循环建立对急性期脑梗死患者预后的影响[J].广东医学院学报,2016,34(6):562-565.
• [6]张岐平,陈英道,李育英,等.侧支循环的建立对急性脑梗死患者神经功能及预后的影响[J].实用医学杂志,2016,32(7):1040-1043.
• [7]袁彬,袁晓梅,张黎军,等.尤瑞克林治疗动脉粥样硬化血栓形成性脑梗死患者疗效观察[J].医学院学报,2016,33(7):606-609.
• [8]朱伊璞.尤瑞克林治疗急性脑梗死的临床疗效观察及可能的机制探讨[D].石家庄:河北医科大学,2014:1-37.
• [9]王宇卉,张文波,郑赟赟,等.尤瑞克林对急性脑梗死患者脑循环动力学的影响[J].中国卒中杂志,2009,4(12):989-993.
• [10]马虹印,吕珊,靳航,等.尤瑞克林对急性缺血性卒中患者脑血流自动调节能力的影响[J].中风与神经疾病杂志,2017,34(2):133-136.
• [11]王照,游三丽.尤瑞克林对前循环急性脑梗死患者侧支循环的影响[J].医学临床研究,2015(2):325-327.
• [12]刘畅,寇雨霏,罗德欣.尤瑞克林对急性脑梗死患者血小板的影响及临床效果[J].华南国防医学杂志,2015,29(1):26-28.
• [13]何晓晓,刘雨薇,刘承云,等.尤瑞克林对急性脑梗死患者红细胞压积及凝血指标水平的影响:回顾性队列研究[J].卒中与神经疾病,2017,24(1)52-55.
• [14]段淑娟.尤瑞克林治疗急性前循环脑梗死近期临床效果初步评定及研究[J].中国实用医药,2016,11(17):210-212.
• [15]史壮宏,李浩,朱艳春,等.注射用尤瑞克林治疗急性进展型脑梗死患者32例的疗效观察[J].中风与神经疾病,2017,34(4):359-360.
• [16]罗宁,邓彦.25例急性前循环脑梗死患者临床治疗中尤瑞克林的价值探讨[J].白求恩医学杂志,2016,14(4):469-471.
• [17]陈卫民,曾桄伦,江国荣.尤瑞克林对急性脑梗死患者甲襞微循环状态的影响观察[J].北方药学,2016,13(10):31-32.
• [18]李秀芹,高勇.阿托伐他汀联合尤瑞克林对急性脑梗死患者临床疗效及内皮素水平的影响[J].中国老年学,2016,36(9):2146-2148.
• [19]闫江.尤瑞克林注射液改善老年急性脑梗死患者预后的临床研究[J].实用药物与临床,2017,20(5):88-89.
• [20]莫俊宁,李又佳,黄燕.人尿激肽原酶对脑梗死灶周围侧支循环建立的作用[J].中国临床研究,2017,30(3):289-293.