CAJ | 학술논문

背景:D-二聚体是交联纤维被纤溶酶降解的特异标志物,脑出血时D-二聚体显著升高,其下降可能反映了血肿的吸收过程,并与脑实质的损伤密切相关.内皮素在脑出血时明显增高,可导致神经组织细胞缺血坏死,脑出血患者内皮素含量能反映疾病的严重程度及其功能预后状况.目的:观察醒脑静合生脉注射液对脑出血急性期患者D-二聚体和内皮素的影响.设计:随机对照研究.单位:青岛大学医学院附属医院急诊内科,济南军区总医院病理科.对象:选择1999-09/2001-05青岛大学医学院附属医院急诊科脑出血急性期留观察患者46例,随机分为两组,即醒脑静合生脉注射液治疗组(23例)和醒脑静治疗组(21例).方法:分别用ELISA法测定患者治疗前后外周血D-二聚体、内皮素水平,用SPSS 8.0统计软件处理数据.主要观察指标:醒脑静合生脉注射液对脑出血急性期患者的D-二聚体、内皮素水平的影响,并与醒脑静组进行比较.结果:醒脑静合生脉注射液能显著降低患者的D-二聚体[治疗前后分别为(0.67±0.21),(0.34±0.18)mg/L,P＜0.01]和内皮素水平[(94.52±30.23),(51.30±21.62)ng/L,P＜0.01],改善程度明显优于醒脑静组[两组分别为(0.33±0.11),(0.20±0.08)mg/L,P＜0.01;(43.22±12.06),(26.52±8.13)ng/L,P＜0.01].结论:改善脑出血患者的纤溶状态,可保护损伤的脑实质,阻止脑出血后的继发性损伤;抑制脑出血后脑血管的痉挛,可改善脑组织的缺血缺氧状态,可能是醒脑静合生脉注射液发挥疗效的途径之一.
배경:D-이취체시교련섬유피섬용매강해적특이표지물,뇌출혈시D-이취체현저승고,기하강가능반영료혈종적흡수과정,병여뇌실질적손상밀절상관.내피소재뇌출혈시명현증고,가도치신경조직세포결혈배사,뇌출혈환자내피소함량능반영질병적엄중정도급기공능예후상황.목적:관찰성뇌정합생맥주사액대뇌출혈급성기환자D-이취체화내피소적영향.설계:수궤대조연구.단위:청도대학의학원부속의원급진내과,제남군구총의원병이과.대상:선택1999-09/2001-05청도대학의학원부속의원급진과뇌출혈급성기류관찰환자46례,수궤분위량조,즉성뇌정합생맥주사액치료조(23례)화성뇌정치료조(21례).방법:분별용ELISA법측정환자치료전후외주혈D-이취체、내피소수평,용SPSS 8.0통계연건처리수거.주요관찰지표:성뇌정합생맥주사액대뇌출혈급성기환자적D-이취체、내피소수평적영향,병여성뇌정조진행비교.결과:성뇌정합생맥주사액능현저강저환자적D-이취체[치료전후분별위(0.67±0.21),(0.34±0.18)mg/L,P＜0.01]화내피소수평[(94.52±30.23),(51.30±21.62)ng/L,P＜0.01],개선정도명현우우성뇌정조[량조분별위(0.33±0.11),(0.20±0.08)mg/L,P＜0.01;(43.22±12.06),(26.52±8.13)ng/L,P＜0.01].결론:개선뇌출혈환자적섬용상태,가보호손상적뇌실질,조지뇌출혈후적계발성손상;억제뇌출혈후뇌혈관적경련,가개선뇌조직적결혈결양상태,가능시성뇌정합생맥주사액발휘료효적도경지일.
BACKGROUND: D-dimer is the specific marker of cross-link fibers degraded by fibrinolysin. During cerebral hemorrhage, D-dimer is significantly increased; its decrease may reflect the absorption process of hematoma and be closely related with the substantial injuries of brain. Endothelin is remarkably increased during cerebral hemorrhage, which may result in ischemic necrosis of neural histiocytes. The endothelin volume in cerebral hemorrhagic patients can reflect the severity of illness and the function prognosis.OBJECTIVE: To observe the effect of xingnaojing he shengmai injection (compound injection) on D-dimer and endothelin in patients at acute stage of cerebral hemorrhage.DESIGN: A randomized and controlled trial.SETTING: Emergent Internal Department of the Affiliated Hospital of Medical College of Qingdao University and Department of Pathology of Jinan Military General Hospital.PARTICIPANTS: A total of 44 patients of inspected patients at acute stage of cerebral hemorrhage were collected in Emergent Internal Department of affiliated Hospital of Medical College of Qingdao University from September 1999 to May 2001, which were randomized into two groups, named as xingnaojing he shengmai injection(compound injection) group(23 patients) and xingnaojing group(21 patients).METHODS: ELISA method was applied to determine the level of D-dimer and endothelin of peripheral blood before and after treatment. SPSS 8.0 statistical software was applied to analyze the data.MAIN OUTCOME MEASURES: Effects of xingnaojing he shengmai injection(compound injection) on level of D-dimer and endothelin in patients at acute stage of cerebral hemorrhage, compare with xingnaojing group.RESULTS: Xingnaojing he shengmai injection(compound injection) significantly reduced the level of both D-dimer[ (0. 67 ± 0. 21), (0.34 ± 0.18) mg/L,P ＜ 0.01 ] and endothelin[ (94.52 ±30. 23), (51.30 ± 21.62) ng/L, P＜ 0.01 ] before and after treatment respectively. The improvement of which was obviously superior to those in xingnaojing group[ (0. 33 ±0. 11),(0.20±0.08)mg/L, P ＜0.01; (43.22±12.06), (26.52±8.13)ng/L respectively, concerning to the improvements in two groups, P ＜ 0. 01 ].CONCLUSION: To improve the fibrinolytic state in patients with cerebral hemorrhage may protect the substantial injuries of brain and prevent the secondary damage after cerebral hemorrhage. To inhibit cerebral vascular spasm after hemorrhage may improve ischemic oxygen deficiency in brain tissue and probably be taken as one of the ways for xingnaojing he shengmai injection giving play to its therapeutic effects.