CAJ | 학술논문

目的：观察降纤酶在治疗脑梗塞急性期过程中对活化部分凝血活酶时间（activated partial thromboplastin time，APTT）、血浆凝血酶原时间（prothrombin time，PT）及血液流变学的影响。方法选取河南省南阳市中心医院神经康复科收治的脑梗塞患者46例，随机分为2组，其中对照组23例，予5％低分子右旋糖酐与维脑路通注射液静脉滴注常规治疗，1周为1个疗程，治疗2个疗程；实验组23例，予降纤酶10 U静脉滴注，1次/2天，1周为1个疗程，治疗2个疗程。治疗结束后，对比治疗前后2组患者APTT、PT及血液流变学。结果治疗后2组患者APTT均有所改善，且实验组APTT较对照组明显上升，差异有统计学意义（P＜0.05）；治疗后2组患者PT均有所改善，且实验组PT较对照组明显上升，差异有统计学意义（P＜0.05）；治疗后2组患者血液流变学（包括高切变率、低切变率、血浆粘度、红细胞压积及纤维蛋白原）均有所改善，且实验组高切变率、血浆粘度、纤维蛋白原较对照组明显下降，差异有统计学意义（P＜0.05）。结论降纤酶能够明显改善脑梗塞急性期的APTT、PT及血液流变学指标，对临床具有指导意义，值得临床推广。
목적：관찰강섬매재치료뇌경새급성기과정중대활화부분응혈활매시간（activated partial thromboplastin time，APTT）、혈장응혈매원시간（prothrombin time，PT）급혈액류변학적영향。방법선취하남성남양시중심의원신경강복과수치적뇌경새환자46례，수궤분위2조，기중대조조23례，여5％저분자우선당항여유뇌로통주사액정맥적주상규치료，1주위1개료정，치료2개료정；실험조23례，여강섬매10 U정맥적주，1차/2천，1주위1개료정，치료2개료정。치료결속후，대비치료전후2조환자APTT、PT급혈액류변학。결과치료후2조환자APTT균유소개선，차실험조APTT교대조조명현상승，차이유통계학의의（P＜0.05）；치료후2조환자PT균유소개선，차실험조PT교대조조명현상승，차이유통계학의의（P＜0.05）；치료후2조환자혈액류변학（포괄고절변솔、저절변솔、혈장점도、홍세포압적급섬유단백원）균유소개선，차실험조고절변솔、혈장점도、섬유단백원교대조조명현하강，차이유통계학의의（P＜0.05）。결론강섬매능구명현개선뇌경새급성기적APTT、PT급혈액류변학지표，대림상구유지도의의，치득림상추엄。
Objective To observe the effect of defibrase on activated partial thromboplastin time (APTT),prothrombin time (PT)and the blood rheology at the acute stage of cerebral infarction.Methods 46 cases of cerebral infarction were selected in the Nanyang City Center Hospital.They were randomly divided into two groups;23 cases of control group,with regular treatment of 5% low molecular dextran and venoruton injection,intravenous drip,one week for a course,for two courses of treatment;23 cases of experimental group,with 10U defibrase,intravenous drip,every two days,one week for a course,for two courses of treatment.After treatment,APTT,PT and blood rheology were compared before and after treatment.Results APTT were improved in both groups after treatment,and APTT in experimental group was higher than that in control group,and the difference was statistically significant (P<0.05 );PT were improved in both groups after treatment,and the experimental group was higher than that in control group,and the difference was statistically significant (P<0.05);the blood rheology were improved in two groups after treatment (including high shear rate,low shear rate,plasma viscosity,erythrocyte deposited and fibrinogen),and the high shear rate,plasma viscosity,and fibrinogen of experimental group were lower than those of control group,and the differences was statistically significant (P<0.05 ).Conclusion Defibrase could obviously improve the APTT,PT and hemorheology indexes of cerebral infarction at the acute stage,which gives a clinical guidance.