【作者】 马丽丽；

【导师】 王兆钺； 尹明达；

【作者基本信息】 苏州大学 ， 血液内科， 2007， 硕士

【摘要】 目的:研究藻酸双酯钠治疗急性脑梗死的临床疗效及其作用机理。方法:将发病一周内的急性脑梗死患者随机分藻酸双酯钠（PSS）、阿司匹林（ASA）与噻氯匹定（TP）三组,观察治疗前及治疗后3、7、14天的血小板聚集率（PAGR）、P-选择素、血栓烷B₂（TXB₂）、凝血酶原时间（PT）、活化的部分凝血活酶时间（APTT）、凝血酶时间（TT）、血浆纤维蛋白原（Fg）、血清脂质的改变,并观察治疗前后临床神经功能状况。结果:（1）PSS对ADP与花生四烯酸（AA）诱导的血小板聚集（PAG）均有一定的抑制作用,而ASA对AA诱导的PAG作用更显著,TP主要抑制ADP诱导的PAG。（2）PSS、ASA、TP均有降低血浆P-选择素浓度作用。ASA能明显降低血浆TXB₂浓度,PSS、TP降低血浆TXB₂浓度作用不明显。（3）PSS延长APTT,对PT轻度延长,对TT与Fg作用不大。ASA、TP对以上指标均无影响。（4）PSS有明显降脂效果,而ASA、TP无降脂作用。（5）PSS组患者的神经功能恢复优于ASA与TP组。结论:PSS具有降脂、抗凝作用,并具有一定抗血小板作用,能在多个环节上发挥抗血栓作用,有效改善急性脑梗死患者神经功能缺损症状,并提高其日常生活能力。更多还原

【Abstract】 Objective:To study clinical effect of polysaccharide sulfate in patients with acute celebral infarct(ACI)and its mechanism.Methods:Patients suffering from ACI within one week were randomly devided into 3 groups receiving polysaccharide sulfate(PSS), aspirin(ASA)and ticlopidine(TP),respectively.The following indices were measured before treatment and 3d,7d,14d after treatment:platelet aggregation rate(PAGR),plasma P-selectin,thromboxane B2(TXB2)in patients, PT,APTT,TT,fibrinogen(Fg),serum lipids as well as nervous function.Results:①PSS inhibited PAG induced by ADP and arachidonic acid (AA).While ASA mainly inhibited AA-induced PAG,and TP mainly inhibited ADP-induced PAG.②PSS,ASA and TP decreased the level of plasma P-selectin after treatment,the level of plasma TXB2 was decreased significantly by ASA after treatment,but not by PSS or TP.③APTT was prolonged by PSS,and PT was slightly prolonged,while TT and Fg was not changed.On the other hand,ASA and TP had no effect on coagulation tests.④serum lipid was significantly decreased by PSS,but not by ASA or TP.⑤nervous function was better recovered in PSS group than ASA and TP groups.Conclusion:PSS shows an antithrombotic effect through lipid decrease,coagulation inhibition and platelet inhibition.Therefore,it can remarkably improve nervous function deficiency of ACI patients and their life ability.更多还原