【摘要】 目的:联合应用TCD及CTP观察尤瑞克林对大面积脑梗死患者的临床疗效。方法:将62例大面积脑梗死患者,随机分为尤瑞克林治疗组(试验组)和常规治疗组(对照组)各31例;两组患者均给予常规内科处理(包括合并高血压、糖尿病、心脏病等的一般药物治疗),试验组在常规治疗的基础上加用尤瑞克林治疗。采用NIHSS评分评价患者神经功能缺损变化,采用Barthel指数记分法评定日常生活活动能力(ADL)。记录患者治疗前及治疗后14、30、90 d的NIHSS评分和BI指数。应用TCD对患侧的Vmean、Qmean、Zc、R和DR进行治疗前后的比较。应用CT灌注成像分析治疗前及治疗后梗死区rCBF、rCBV、rTTP和r MTT指标。结果:治疗前两组患者NIHSS评分、Barthel指数、TCD及CTP的各检测指标比较,差异无显著统计学意义(P>0.05);经2周治疗后,发现两组患者上述指标均较治疗前明显改善(P<0.05);但尤瑞克林组的改善幅度尤为显著,两组间差异均具有显著性意义(P<0.05)。结论:尤瑞克林可明显改善大面积脑梗死患者的神经功能缺损和日常生活能力,作用机制可能是通过改善梗死区的微循环和血流再灌注。更多还原

【Abstract】 Objective To investigate the efficacy of Human Urinary Kallikrein in the treatment of massive cerebral infarction(MCI) combination of TCD and CTP. Method Sixty-two patients with MCI were randomly divided into the groups treatment and control. All the patients were given a basic therapy. Human Urinary Kallikrein was administrated to the patients in the treatment group for 14 days in addition to the basic therapy. All the patients have been evaluated by NIHSS and BI before treatment and at days 14,30 and 90 after the treatment. TCD was applied to compare Vmean,Qmean,Zc,R and DR in affected side before and after treatment. r CBF,r CBV,r TTP and r MTT indexes were analyzed before and after treatment with CT perfusion imaging. Results No changes were shown ragarding NIHSS,BI,TCD and CTP before treatment in both groups( P > 0. 05). There were significantly difference regarding those between the both groups after treatment( P < 0. 05),especially in treatment group. Compared with control group,NIHSS and BI were improved at 14 d,30 d,90 d after treatment in treatment group,there was significantly difference between both groups( P < 0. 05). Conclusion Human Urinary Kallikrein can obviously improve the neurological deficits and activities of daily living in patients with massive cerebral infarction,and the mechanism may be to improve the microcirculation and flow reperfusion of the infarcted area.更多还原