CAJ | 학술논문

目的：探讨在脑梗死后不同治疗时间窗应用人尿激肽原酶（尤瑞克林）的疗效差异。方法：将急性脑梗死91例患者随机分为3组，A组30例予阿司匹林和他汀类药物治疗；B组31例，在A组治疗的基础上，发病24h内加用人尿激肽原酶；C组30例，在A组治疗的基础上，发病24~48小时予人尿激肽原酶治疗。采用NIHSS评分评价患者的神经功能缺损，BI评价患者的日常生活能力，分别比较3组治疗前后及各组间的NIHSS评分和BI。结果：治疗前NIHSS评分A组为10.23±1.08分，B组为10.94±1.13分，C组为11.37±1.25分，3组比较差异无统计学意义（P＞0.05）；治疗后2周NIHSS评分A组为7.98±0.87分，B组为5.78±0.63分，C组为6.02±0.67分，3组NIHSS评分与治疗前比显著下降（P＜0.05），B组和C组的NIHSS评分明显低于A组（P＜0.05）；B、C两组之间NIHSS评分无显著差异（P＞0.05）。治疗前BI评分A组为17.89±1.98分，B组为18.13±1.78分，C组为19.27±2.13分，治疗后3月BI评分A组为51.54±5.94分，B组为68.12±7.83分，C组为66.54±7.68分，3组比较差异无统计学意义（P＞0.05）；治疗后3个月，3组的BI与治疗前比显著增高（P＜0.05），B、C组的BI明显高于A组（P＜0.05）；B、C组之间比较差异均无统计学意义（P＞0.05）。结论：与阿司匹林、他汀类药物联合应用，人尿激肽原酶对急性期脑梗死患者疗效明显，脑梗死后24小时内和24~48小时内使用的疗效相近。
목적：탐토재뇌경사후불동치료시간창응용인뇨격태원매（우서극림）적료효차이。방법：장급성뇌경사91례환자수궤분위3조，A조30례여아사필림화타정류약물치료；B조31례，재A조치료적기출상，발병24h내가용인뇨격태원매；C조30례，재A조치료적기출상，발병24~48소시여인뇨격태원매치료。채용NIHSS평분평개환자적신경공능결손，BI평개환자적일상생활능력，분별비교3조치료전후급각조간적NIHSS평분화BI。결과：치료전NIHSS평분A조위10.23±1.08분，B조위10.94±1.13분，C조위11.37±1.25분，3조비교차이무통계학의의（P＞0.05）；치료후2주NIHSS평분A조위7.98±0.87분，B조위5.78±0.63분，C조위6.02±0.67분，3조NIHSS평분여치료전비현저하강（P＜0.05），B조화C조적NIHSS평분명현저우A조（P＜0.05）；B、C량조지간NIHSS평분무현저차이（P＞0.05）。치료전BI평분A조위17.89±1.98분，B조위18.13±1.78분，C조위19.27±2.13분，치료후3월BI평분A조위51.54±5.94분，B조위68.12±7.83분，C조위66.54±7.68분，3조비교차이무통계학의의（P＞0.05）；치료후3개월，3조적BI여치료전비현저증고（P＜0.05），B、C조적BI명현고우A조（P＜0.05）；B、C조지간비교차이균무통계학의의（P＞0.05）。결론：여아사필림、타정류약물연합응용，인뇨격태원매대급성기뇌경사환자료효명현，뇌경사후24소시내화24~48소시내사용적료효상근。
Objective:To investigate the treatment efficacy of human urinary kallidinogenase in different time after acute cerebral infarction. Methods: 91 patients participated in the study. 30 patients treated only with standardized treat-ment after ischemic stroke onset were assigned as group A. 31 patients treated with standardized treatment and human uri-nary kallidinogenase within 24 hours after ischemic stroke onset were assigned as group B. Another 30 patients treated with standardized treatment and human urinary kallidinogenase within 24 to 48 hours after ischemic stroke onset were assigned as group C. The comparison of treatment efficacy of human urinary kallidinogenase among the three groups and each group before treatment, National Institutes of Health Stroke scale (NIHSS) and Barthel Index (BI) were applied. Result: Before treatment, the NIHSS scores of A,B and C groups were 10.23±1.08, 10.94±1.13 and 11.37±1.25 respectively. Two weeks after treatment, the NIHSS scores of A,B and C groups were 7.98±0.87, 5.78±0.63 and 6.02±0.67. Before treatment, the BI scores of A,B and C groups were 17.89±1.98, 18.13±1.78, 19.27±2.13 respectively. After three months , the BI scores of A, B and C groups were 51.54±5.94, 68.12±7.83, 66.54±7.68 respectively. Before treatment, the NIHSS scores and BI of three groups had no significant difference (P>0.05). Two weeks after treatment, the NIHSS scores of every group were obviously decreased compared with before treatment (P<0.05). The NIHSS scores of group B and group C decreased more obviously than group A(P<0.05), there was no obvious difference in B and C. (P>0.05). Three months after treatment, the BI scores of every group were obviously increased compared with those before treatment(P<0.05). The BI scores of group B and group C increased more obviously than group A(P<0.05), and there was no obvious difference in the BI scores in B and C (P>0.05). Conclusion: Human urinary kallidinogenase has good treatment efficacy to patients with acute cerebral infarction. The treatment efficacy of human urinary kallidinogenase is the same in different periods of time after acute cerebral infarction.