CAJ | 학술논문

目的：观察尤瑞克林联合奥扎格雷钠治疗急性脑梗死的临床疗效及对患者血液流变学指标的影响。方法选择100例符合入组标准的急性脑梗死患者按随机数字表法分为观察组50例和对照组50例，对照组给予常规药物综合治疗，观察组在对照组的基础上再给予尤瑞克林与奥扎格雷钠联合治疗，14 d 为1个疗程，疗程结束后观察患者症状改善情况，进行神经功能缺损评分（NIHSS 评分）与日常生活活动能力量表评分（ADL），检测血液流变学指标变化情况（包括全血高切黏度、红细胞聚集指数、红细胞比容、纤维蛋白原、红细胞沉降率），评价两组患者临床疗效。结果观察组总有效率为96％（48／50），对照组的总有效率为66％（33／50），观察组总有效率明显高于对照组（χ2＝16．105，P ＜0．01）；观察组和对照组治疗后全血高切黏度、红细胞聚集指数、红细胞比容、纤维蛋白原、红细胞沉降率、NHISS 评分较明显低于治疗前，差异均有统计学意义（t ＝6．589、3．762、6．204、3．661、8．112、5．774、5．542、3．529、9．429、3．962、9．621、6．586，均 P ＜0．05）， ADL 评分均明显高于治疗前，差异有统计学意义（t ＝7．673、5．446，均 P ＜0．05），观察组治疗后血高切黏度、红细胞聚集指数、红细胞比容、纤维蛋白原、红细胞沉降率、NHISS 评分较明显低于对照组，差异均有统计学意义（t ＝3．387、3．545、3．525、3．288、3．302、4．988，均 P ＜0．05），ADL 评分明显高于对照组，差异有统计学意义（t ＝3．446，P ＜0．05）。结论尤瑞克林与奥扎格雷钠联合治疗急性脑梗死的临床疗效确切，能够有效改善血液流变学，促进神经功能缺损改善及日常生活能力恢复，且安全性良好，值得推广。
목적：관찰우서극림연합오찰격뢰납치료급성뇌경사적림상료효급대환자혈액류변학지표적영향。방법선택100례부합입조표준적급성뇌경사환자안수궤수자표법분위관찰조50례화대조조50례，대조조급여상규약물종합치료，관찰조재대조조적기출상재급여우서극림여오찰격뢰납연합치료，14 d 위1개료정，료정결속후관찰환자증상개선정황，진행신경공능결손평분（NIHSS 평분）여일상생활활동능역량표평분（ADL），검측혈액류변학지표변화정황（포괄전혈고절점도、홍세포취집지수、홍세포비용、섬유단백원、홍세포침강솔），평개량조환자림상료효。결과관찰조총유효솔위96％（48／50），대조조적총유효솔위66％（33／50），관찰조총유효솔명현고우대조조（χ2＝16．105，P ＜0．01）；관찰조화대조조치료후전혈고절점도、홍세포취집지수、홍세포비용、섬유단백원、홍세포침강솔、NHISS 평분교명현저우치료전，차이균유통계학의의（t ＝6．589、3．762、6．204、3．661、8．112、5．774、5．542、3．529、9．429、3．962、9．621、6．586，균 P ＜0．05）， ADL 평분균명현고우치료전，차이유통계학의의（t ＝7．673、5．446，균 P ＜0．05），관찰조치료후혈고절점도、홍세포취집지수、홍세포비용、섬유단백원、홍세포침강솔、NHISS 평분교명현저우대조조，차이균유통계학의의（t ＝3．387、3．545、3．525、3．288、3．302、4．988，균 P ＜0．05），ADL 평분명현고우대조조，차이유통계학의의（t ＝3．446，P ＜0．05）。결론우서극림여오찰격뢰납연합치료급성뇌경사적림상료효학절，능구유효개선혈액류변학，촉진신경공능결손개선급일상생활능력회복，차안전성량호，치득추엄。
Objective To observe the effect of kallikrein and ozagrel on hemorheology in the treatment of patients with acute cerebral infarction,provide a theoretical basis for clinical treatment.Methods 100 patients with acute cerebral infarction met the inclusion criteria were randomly divided into 50 cases of observation group and 50 cases of control group,the control group were received conventional drug therapy,the observation group were given kallikrein and ozagrel on the basis of the control group,kallikrein 0.15PNA /times,ozagrel 80mg one time,bid,14d for a course of treatment.The symptoms improvement were observed,the NIHSS score and ADL score were calculated after treatment,then the blood were extraced for detecting high shear viscosity of whole blood,red blood cell aggrega-tion index,hematocrit,fibrinogen,erythrocyte sedimentation rate,and the clinical efficacy were judged.Results The total effective rate of the observation group were 96% (48 /50),which of the control group were 66% (33 /50),the total effective of the observation group was significantly higher than the control group (χ2 =16.105,P <0.01);The high shear viscosity of whole blood,red blood cell aggregation index,hematocrit,fibrinogen,erythrocyte sedimentation rate,NHISS of the observation group and the control group after treatment were lower than before treatment (t =6.589 and 3.762,6.204 and 3.661,8.112 and 5.774,5.542 and 3.529,9.429 and 3.962,9.621 and 6.586,all P <0.05),the ADL score was significantly higher than before treatment(t =7.673 and 5.446,all P <0.05),the high shear viscosity of whole blood,red blood cell aggregation index,hematocrit,fibrinogen,erythrocyte sedimentation rate, NHISS of the observation group after treatment were lower than those of the control group (t =3.387,3.545,3.525, 3.288,3.302,4.988,all P <0.05),the ADL score was significantly higher than the control group (t =3.446,P <0.05).Conclusion The method containing kallikrein and ozagrel has exact clinical efficacy,can effectively improve blood rheology and cerebral blood perfusion ischemic area,promote neurological deficits and recover the ability of daily life,and its security is good,which is worthy of promotion.