普罗布考对进展性脑梗塞患者APTT、FIB、血液流变学及炎症指标的影响

发布时间：2018-01-19 20:14

本文关键词： 普罗布考进展性脑梗塞活化的部分凝血活酶时间血浆纤维蛋白原血液流变学超敏c反应蛋白基质金属蛋白酶9　出处：《西南医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨普罗布考对进展性脑梗塞患者的神经功能恢复情况、活化部分凝血活酶时间(Activated Partial Thromboplastin Time,APTT)、纤维蛋白原(Fibrinogen,FIB)、血液流变学、超敏c反应蛋白(Hypersensitive C-reactive Protein,hs-CRP)、基质金属蛋白酶9(Matrix metallopeptidase 9,MMP-9)的影响,观察普罗布考对进展性脑梗塞患者的治疗效果,为普罗布考治疗脑梗塞的临床应用提供一定的依据。方法:采取随机对照试验设计研究方案,纳入某院神经内科收治的80例进展性脑梗塞患者为研究对象,经患者知情同意且签定知情同意书后,随机分为研究组和对照组,每组各40例。分别对两组患者年龄构成、性别构成、体重构成、常规检查指标、伴发疾病情况等因素进行统计学分析,均无统计学差异。对照组采取常规治疗方案,研究组在对照组常规治疗方案的基础上加用普罗布考,每次0.5g,每日2次,早、晚餐时服用,分别于治疗前、治疗15天后、治疗30天后比较两组患者的神经功能缺损评分、患者总的生活能力状态分级、APTT、FIB、血液流变学、hs-CRP、MMP-9的变化情况,治疗结束后比较两组的临床总疗效,同时比较两组间不良反应发生情况。结果:(1)研究组患者治疗后神经功能缺损评分、患者总的生活能力状态分级、均较治疗前有改善,且治疗后30天的指标优于治疗后15天(P0.05),研究组患者在神经功能缺损评分、患者总的生活能力状态分级较同期对照组均有改善,均有统计学差异(P0.05);研究组临床疗效高于对照组(P0.05)。(2)研究组患者治疗后的APTT较治疗前延长,且APTT治疗后30天较治疗后15天延长,研究组患者治疗后的APTT较对照组同期患者均升高,均具有统计学差异(P0.05);(3)研究组患者治疗后的FIB水平较治疗前降低,且治疗后30天FIB水平低于治疗后15天,研究组患者治疗后的FIB水平较对照组同期患者均降低,均具有统计学差异(P0.05);(4)研究组患者治疗后的血浆粘度、全血高切粘度及全血低切粘度较治疗前均降低,且上述指标治疗后30天低于治疗后15天,研究组患者治疗后的血浆粘度、全血高切粘度及全血低切粘度较对照组同期患者均降低,均具有统计学差异(P0.05)。(5)研究组患者治疗后hs-CRP较治疗前降低,且上述指标治疗后30天低于治疗后15天,研究组患者治疗后hs-CRP较对照组同期患者均降低,均具有统计学差异(P0.05)。(6)研究组患者治疗后MMP-9较治疗前降低,且上述指标治疗后30天低于治疗后15天,研究组患者治疗后的MMP-9较对照组同期患者均降低,均具有统计学差异(P0.05)。结论:普罗布考治疗对进展性脑梗塞患者的疗效显著,能够延长APTT,降低FIB水平,降低血浆粘度、全血高切粘度及全血低切粘度、hs-CRP、MMP-9,明显改善脑梗塞患者神经功能缺损及生活能力状态。
[Abstract]:Objective: to investigate the recovery of nerve function in patients with progressive cerebral infarction treated with probucol. Activated partial thromboplastin time (APTT). Fibrinogen, hemorheology, hypersensitive C-reactive Protein. Hs-CRP, matrix metalloproteinase 9 matrix metallopeptidase 9 (MMP-9). To observe the therapeutic effect of Probucol on patients with progressive cerebral infarction, and to provide some basis for the clinical application of probucol in the treatment of cerebral infarction. Eighty patients with progressive cerebral infarction admitted to a department of neurology were randomly divided into study group and control group after informed consent and informed consent was signed. Each group of 40 cases. The two groups of patients age composition, gender composition, body weight composition, routine examination indicators, accompanied by disease and other factors were statistically analyzed. There was no statistical difference. The control group was treated with routine therapy, the study group was treated with probucol on the basis of routine treatment, 0.5g per day, 2 times a day, early and dinner. Before treatment, 15 days after treatment, 30 days after treatment, the neurological impairment scores, total life ability status of patients and APTTT FIBs, hemorheology were compared between the two groups. The changes of MMP-9 in hs-CRP were compared between the two groups after the end of treatment. At the same time, the adverse reactions between the two groups were compared. Results the neurological deficit score and the total living ability status of the patients in the study group were improved after treatment. The index of 30 days after treatment was better than that of 15 days after treatment (P0.05). The patients in the study group had improved in the neurological function deficit score and the overall living ability grading of the patients compared with the control group in the same period. There was statistical difference between the two groups (P 0.05). The clinical curative effect of the study group was higher than that of the control group (P0.05. 2) the APTT after treatment in the study group was longer than that before treatment, and 30 days after the treatment with APTT was longer than 15 days after the treatment. The APTT of the study group was higher than that of the control group in the same period (P 0.05). The level of FIB in the study group after treatment was lower than that before treatment, and the level of FIB was lower at 30 days after treatment than that at 15 days after treatment. The level of FIB in the study group was lower than that in the control group (P 0.05). (4) the plasma viscosity, whole blood high shear viscosity and whole blood low shear viscosity of the patients in the study group were lower than those before treatment, and 30 days after treatment were lower than 15 days after treatment. The plasma viscosity, whole blood high shear viscosity and whole blood low shear viscosity of the patients in the study group were lower than those in the control group. The hs-CRP of study group was lower than that before treatment, and 30 days after treatment was lower than that of 15 days after treatment. The hs-CRP of the study group was lower than that of the control group in the same period, and the difference was statistically significant (P < 0.05) the MMP-9 of the study group was lower than that of the control group (P < 0.05). The MMP-9 of the study group was lower than that of the control group at 30 days after treatment and 15 days after treatment. Conclusion: Probucol treatment in patients with progressive cerebral infarction has a significant effect, can prolong APTT, reduce the level of FIB, reduce plasma viscosity. The high shear viscosity of whole blood and the low shear viscosity of whole blood hs-CRPU MMP-9 significantly improved the neurological function defect and living ability of patients with cerebral infarction.
【学位授予单位】：西南医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

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