中国医师杂志
中國醫師雜誌
중국의사잡지
JOURNAL OF CHINESE PHYSICIAN
2013年
3期
334-337
,共4页
余辉云%向入平%万燕%禹小杜%王理
餘輝雲%嚮入平%萬燕%禹小杜%王理
여휘운%향입평%만연%우소두%왕리
尿纤溶酶原激活物/治疗应用%血栓溶解疗法%脑梗死/治疗%神经症性障碍%基质金属蛋白酶9/血液
尿纖溶酶原激活物/治療應用%血栓溶解療法%腦梗死/治療%神經癥性障礙%基質金屬蛋白酶9/血液
뇨섬용매원격활물/치료응용%혈전용해요법%뇌경사/치료%신경증성장애%기질금속단백매9/혈액
Urinary plasminogen activator/therapeutic use%Thrombolytic therapy%Brain infarction/therapy%Neurotic disorders%Matrix metalloproteinase 9/blood
目的 探讨尿激酶静脉溶栓治疗对脑梗死患者临床及血清金属基质蛋白酶9(MMP-9)浓度的影响.方法 将起病4.5h以内符合溶栓条件的脑梗死患者27例作为观察组,以同期起病超过4.5h的脑梗死患者27例作为对照组.观察组予以尿激酶100万单位静脉注射,24 h后予以阿司匹林300 mg口服；对照组入院后即予以阿司匹林300 mg口服.两组均予以降脂抗动脉硬化、脑保护、康复等常规治疗,比较治疗前、后两组患者不同时间段神经功能缺损变化及血清MMP-9浓度的动态变化.结果 治疗后两组神经功能缺损逐步降低,且1、3、14 d时观察组神经功能缺损评分明显低于对照组,差异有统计学意义[(10.97±1.53)分vs(15.67±1.78)分,t=8.35,P=0.03；(8.15±1.40)分vs(12.72±3.31)分,t=6.62,P=0.03；(5.87±1.03)分vs(11.92±2.05)分,t=13.70,P=0.01].治疗后1、3、14 d观察组患者血清MMP-9浓度均明显低于对照组[(282.84±37.51)ng/ml vs (316.90±36.75)ng/ml,t=3.37,P=0.00;(309.11±37.71)ng/ml vs (348.39±15.26) ng/ml,t=5.02,P=0.04;(264.68±31.91) ng/ml vs (302.81±36.30) ng/ml,t=4.10,P=0.03].结论 尿激酶静脉溶栓治疗能有效减轻脑梗死患者神经功能缺损,减少MMP-9的产生.
目的 探討尿激酶靜脈溶栓治療對腦梗死患者臨床及血清金屬基質蛋白酶9(MMP-9)濃度的影響.方法 將起病4.5h以內符閤溶栓條件的腦梗死患者27例作為觀察組,以同期起病超過4.5h的腦梗死患者27例作為對照組.觀察組予以尿激酶100萬單位靜脈註射,24 h後予以阿司匹林300 mg口服；對照組入院後即予以阿司匹林300 mg口服.兩組均予以降脂抗動脈硬化、腦保護、康複等常規治療,比較治療前、後兩組患者不同時間段神經功能缺損變化及血清MMP-9濃度的動態變化.結果 治療後兩組神經功能缺損逐步降低,且1、3、14 d時觀察組神經功能缺損評分明顯低于對照組,差異有統計學意義[(10.97±1.53)分vs(15.67±1.78)分,t=8.35,P=0.03；(8.15±1.40)分vs(12.72±3.31)分,t=6.62,P=0.03；(5.87±1.03)分vs(11.92±2.05)分,t=13.70,P=0.01].治療後1、3、14 d觀察組患者血清MMP-9濃度均明顯低于對照組[(282.84±37.51)ng/ml vs (316.90±36.75)ng/ml,t=3.37,P=0.00;(309.11±37.71)ng/ml vs (348.39±15.26) ng/ml,t=5.02,P=0.04;(264.68±31.91) ng/ml vs (302.81±36.30) ng/ml,t=4.10,P=0.03].結論 尿激酶靜脈溶栓治療能有效減輕腦梗死患者神經功能缺損,減少MMP-9的產生.
목적 탐토뇨격매정맥용전치료대뇌경사환자림상급혈청금속기질단백매9(MMP-9)농도적영향.방법 장기병4.5h이내부합용전조건적뇌경사환자27례작위관찰조,이동기기병초과4.5h적뇌경사환자27례작위대조조.관찰조여이뇨격매100만단위정맥주사,24 h후여이아사필림300 mg구복；대조조입원후즉여이아사필림300 mg구복.량조균여이강지항동맥경화、뇌보호、강복등상규치료,비교치료전、후량조환자불동시간단신경공능결손변화급혈청MMP-9농도적동태변화.결과 치료후량조신경공능결손축보강저,차1、3、14 d시관찰조신경공능결손평분명현저우대조조,차이유통계학의의[(10.97±1.53)분vs(15.67±1.78)분,t=8.35,P=0.03；(8.15±1.40)분vs(12.72±3.31)분,t=6.62,P=0.03；(5.87±1.03)분vs(11.92±2.05)분,t=13.70,P=0.01].치료후1、3、14 d관찰조환자혈청MMP-9농도균명현저우대조조[(282.84±37.51)ng/ml vs (316.90±36.75)ng/ml,t=3.37,P=0.00;(309.11±37.71)ng/ml vs (348.39±15.26) ng/ml,t=5.02,P=0.04;(264.68±31.91) ng/ml vs (302.81±36.30) ng/ml,t=4.10,P=0.03].결론 뇨격매정맥용전치료능유효감경뇌경사환자신경공능결손,감소MMP-9적산생.
Objective To investigate the effect of intravenous thrombolytic therapy with urokinase on the neurological function and the concentration of serum matrix metalloproteinase 9 (MMP-9) in the patients with acute cerebral infarction.Methods The patients with acute cerebral infarction were divided into the experimental and control groups.The experimental group included 27 patients who were complied with thrombolytic criterion within 4.5 hours after stroke and were firstly treated by intravenous thrombolytic therapy with urokinase by 100 million units after 24 h and 300 mg aspirin by oral.The control group included 27 cases that were directly administrated by 300 mg aspirin 4.5 hours later after stroke.After 24 h,the two groups were administrated with other same conventional treatments such as neurotrophy,improvement of microcirculation,and control of blood-fat.The neurological function and dynamic concentration of serum MMP-9 were observed before treatment and after treatment.Results After treatment,the neurological deficit evaluation score in both groups was gradually reduced with the treatment time,and the neurological deficit evaluation score in the experimental group was significantly lower than that in the control group at the 1 st,3rd,and 14th day,respectively[(10.97 ± 1.53) Score vs (15.67 ±1.78)Score,t =8.35,P =0.03;(8.15 ± 1.40) Score vs(12.72 ± 3.31) Score,t =6.62,P =0.03; (5.87 ± 1.03) Score vs (11.92 ±2.05) Score,t =13.70,P =0.01].After treatment,the concentration of serum MMP-9 in both groups was reduced with the treatment time,and serum MMP-9 in the experimental group was significantly lower than that in the control group at the 1st,3rd,and 14th day,respectively[(282.84 ±37.51) ng/ml vs (316.90±36.75)ng/ml,t =3.37,P =0.00;(309.11±37.71)ng/mlvs (348.39 ±15.26) ng/ml,t =5.02,P=0.04;(264.68±31.91)ng/ml vs (302.81 ±36.30)ng/ml,t =4.10,P =0.03].Conclusions Intravenous thrombolytic therapy with urokinase can effectively reduce the neurological deficit and the produce of MMP-9 in patients with acute cerebral infarction.
