CAJ | 학술논문

目的评价尤瑞克林治疗急性前循环脑梗死的近期疗效和安全性.方法采用随机、单盲、对照设计,纳入珠江医院神经内科自2006年10月至2009年4月收治的61例急性前循环脑梗死患者,并按随机数字表法分为尤瑞克林组(31例)和对照组(30例).两组患者根据病情给予相同的基础治疗,尤瑞克林组存此基础上予以每天0.15 PNA单位尤瑞克林(以100mL生理盐水稀释,30～40滴/min静脉滴注,每天1次,连续14 d).在治疗前及治疗后第21天分别观察两组患者神经功能缺损程度(NIHSS评分)及日常生活能力(mRS评分),并进行血尿常规、肝肾功能、血糖、血脂及心电图等检查,监测血压和脉率,必要时复查头颅CT,观察药物相关的出血性事件及不良反应.结果与对照组相比,尤瑞克林能明显改善患者NIHSS评分和提高mRS评分,差异有统计学意义(P=0.022,P=0.032).依据平均秩次(尤瑞克林组23.86,对照组35.93)判断,尤瑞克林组疗效优于对照组.除尤瑞克林组2例有哮喘病史患者因治疗期间诱发哮喘发作而退出试验外,其他患者未见不良反应.尤瑞克林组用药前后血尿常规、肝肾功能、血糖、血脂及心电图等检查无异常变化,用药后头颅CT检查未见药物相关的出血性事件.结论应用尤瑞克林治疗急性前循环脑梗死患者安全、有效,能显著改善患者神经功能缺损症状和提高日常生活能力.
목적 평개우서극림치료급성전순배뇌경사적근기료효화안전성.방법 채용수궤、단맹、대조설계,납입주강의원신경내과자2006년10월지2009년4월수치적61례급성전순배뇌경사환자,병안수궤수자표법분위우서극림조(31례)화대조조(30례).량조환자근거병정급여상동적기출치료,우서극림조존차기출상여이매천0.15 PNA단위우서극림(이100mL생리염수희석,30～40적/min정맥적주,매천1차,련속14 d).재치료전급치료후제21천분별관찰량조환자신경공능결손정도(NIHSS평분)급일상생활능력(mRS평분),병진행혈뇨상규、간신공능、혈당、혈지급심전도등검사,감측혈압화맥솔,필요시복사두로CT,관찰약물상관적출혈성사건급불량반응.결과 여대조조상비,우서극림능명현개선환자NIHSS평분화제고mRS평분,차이유통계학의의(P=0.022,P=0.032).의거평균질차(우서극림조23.86,대조조35.93)판단,우서극림조료효우우대조조.제우서극림조2례유효천병사환자인치료기간유발효천발작이퇴출시험외,기타환자미견불량반응.우서극림조용약전후혈뇨상규、간신공능、혈당、혈지급심전도등검사무이상변화,용약후두로CT검사미견약물상관적출혈성사건.결론 응용우서극림치료급성전순배뇌경사환자안전、유효,능현저개선환자신경공능결손증상화제고일상생활능력.
Objective To evaluate the short-term therapeutic efficacy and safety of kallikrein in patients with acute anterior circulation cerebral infarction. Methods Sixty-one patients with anterior circulation cerebral infarction, admitted to our hospital from October 2006 to April 2009, were enrolled in the randomized single-blind control trail. These patients were assigned to kallikrein treatment group (n=31) and control group (n=30). They were both treated by identical basis therapy, such as antiplatelet,dilute blood viscosity, neurotrophy therapy and symptomatic treatment. The patients in the treatment group were treated by intravenous infusion administration of 0.15 PNA kallikrein diluted in 100 mL 0.9% saline at 30-40 drops /min once daily for 14 consecutive days. On the pretherapy and 21st post-treatment day, the National Institutes of Health Stroke Scale (NIHSS), activity of daily living (ADL) of modified Rankin Scale (mRS) in these patients were performed;blood routine examinations and urinalysis,hepatorenal function, levels of blood glucose and lipid, and ECG were assessed;blood pressure and pulse rate were monitored. CT scan was employed for ICH if necessary. Drug relative hemorrhage and adverse drug reaction (ADR) were recorded in detail. Results As compared with those in the control group,significantly reduced NIHSS scores and obviously improved ADL scores in the kallikrein treatment group were noted (P=0.022, P=0.032, respectively). According to the mean rank (kallikrein treatment group:23.86, control group: 35.93), the efficacy in the treatment group was better than that in the control group.Except that asthmatic attack happened to 2 patients (having the history of asthma) during treatment period, no other ADRs were noted in all the patients. No abnormal changes of blood routine examinations, urinalysis, hepatorenal function, levels of blood glucose and lipid, and ECG and head CT features in the kallikrein treatment group were detected before and after the treatment;no drug relative hemorrhage was noted either. Conclusion Kallikrein is safe and effective in treating patients with acute anterior circulation cerebral infarction, through reducing the neurologic function impairment and improving ADL.