CAJ | 학술논문

目的：探讨纤溶酶对急性脑梗死（ ACI）患者血浆血栓前体蛋白（ TpP）水平的影响及意义。方法92例病程＜72 h的ACI患者随机分为常规药物治疗组（ A组，47例）和纤溶酶治疗组（ B组，45例）。在治疗前、治疗后24 h、48 h、72 h，采用ELISA法测定血浆TpP水平，并与43名健康体检者（对照组）比较。采用NIHSS、出院后3个月的日常生活活动能力（ ADL）量表评价患者的临床疗效。结果与对照组比较， A、B两组患者治疗前血浆TpP水平明显升高（均P＜0．01）。与A组比较，B组患者治疗后各时间点血浆TpP水平、NIHSS评分均明显降低（均P＜0．05）。与治疗前比较，A、B两组患者治疗后各时间点血浆TpP水平明显降低；B组患者治疗后各时间点NIHSS评分明显降低（均P＜0．05）。 A组的ADL评分[（89．87±10．13）分]与B组[（82．16±16．09）分]比较，差异无统计学意义（t＝1．870，P＝0．067）。但是，B组康复效益大的比例明显高于A组（χ2＝5．842，P＜0．05）。 A、B两组均未见严重不良反应。结论纤溶酶能降低ACI患者血浆TpP水平，减少神经功能缺损，改善临床预后，且无明显不良反应，值得推广。
목적：탐토섬용매대급성뇌경사（ ACI）환자혈장혈전전체단백（ TpP）수평적영향급의의。방법92례병정＜72 h적ACI환자수궤분위상규약물치료조（ A조，47례）화섬용매치료조（ B조，45례）。재치료전、치료후24 h、48 h、72 h，채용ELISA법측정혈장TpP수평，병여43명건강체검자（대조조）비교。채용NIHSS、출원후3개월적일상생활활동능력（ ADL）량표평개환자적림상료효。결과여대조조비교， A、B량조환자치료전혈장TpP수평명현승고（균P＜0．01）。여A조비교，B조환자치료후각시간점혈장TpP수평、NIHSS평분균명현강저（균P＜0．05）。여치료전비교，A、B량조환자치료후각시간점혈장TpP수평명현강저；B조환자치료후각시간점NIHSS평분명현강저（균P＜0．05）。 A조적ADL평분[（89．87±10．13）분]여B조[（82．16±16．09）분]비교，차이무통계학의의（t＝1．870，P＝0．067）。단시，B조강복효익대적비례명현고우A조（χ2＝5．842，P＜0．05）。 A、B량조균미견엄중불량반응。결론섬용매능강저ACI환자혈장TpP수평，감소신경공능결손，개선림상예후，차무명현불량반응，치득추엄。
Objective To investigate the effects and the significance of fibrinogenase on plasma thrombus precursor protein (TpP) level in patients with acute cerebral infarction (ACI).Methods Ninety-two ACI patients with the course of disease <72 h were divided into conventional drug treatment group ( A group, 47 cases ) and fibrinogenase treatment group ( B group, 45 cases) .The plasma TpP level was detected by ELISA method before and 24 h, 48 h, 72 h after treatment.And the results were compared with those of 43 healthy controls (control group). The clinical efficacy was evaluated by NIHSS and activities of daily life ( ADL) scores at 3 months after treatment. Results Compared with the control group, the plasma TpP levels of A and B groups before treatment were significantly increased ( all P<0.01) .Compared with the A group, the plasma TpP levels and the NIHSS scores of B group at each time point after treatment were significantly decreased ( all P<0.05 ) . Compared with before treatment, the plasma TpP levels of A and B groups at each time point after treatment were significantly decreased, and the NIHSS scores of B group at each time point after treatment were significantly decreased (all P<0.05).The ADL score of A group (89.87 ±10.13) compared with B group (82.16 ±16.09) had no significantly difference. The rate of high rehabilitation efficiency in B group was significantly higher than that in A group (χ2 =5.842,P<0.05).A, B two groups had no serious adverse reactions.Conclusions Fibrinogenase can depress the plasma TpP level of ACI patients, reduce the neurological impairment and improve the clinical outcomes.It has no obvious adverse reactions, which is worth promoting.