尿激肽原酶对急性缺血性脑梗死患者血流动力学及神经功能的影响

发布时间：2018-03-01 15:12

本文关键词： 急性脑梗死尿激肽原酶 CT灌注成像血流动力学侧支循环　出处：《湖北医药学院学报》2016年06期 　论文类型：期刊论文

【摘要】：目的:利用CT灌注成像(CTP)分析人尿激肽原酶1(Human urine kallikrein,HUK1)对急性缺血性脑梗死患者血流动力学及神经功能的影响。方法:筛选69例符合要求的急性脑梗死患者,按2∶1比例随机分为观察组与对照组。对照组给予基础抗血小板治疗(阿司匹林片0.1 g/d,氯吡格雷片75 mg/d);治疗组在上述基础上增加注射用HUK1(0.15 p NA U),行静脉滴注,1次/d,连用3周。治疗前及治疗3周后行CTP检查,观察病变区CTP检测参数(相对脑血流量r CBF、相对脑血容量r CBV及相对达峰时间r TTP);记录入院24 h内及治疗3周患者的NIHSS评分,随访3个月时患者的日常生活能力(mRS评分)。结果:与对照组相比,治疗3周后观察组梗死灶半暗带r CBF(0.84±0.17)、r CBV(0.89±0.25)及r TTP(1.29±0.37)的指标均优于对照组,灌注参数差异有显著性(P0.05);NIHSS评分(3.48±5.69)优于治疗前(11.71±5.62)及对照组(4.98±5.04)(P0.01);治疗3月后随访mRS评分(1.58±1.77)优于对照组(2.36±1.52)(P0.05)。结论:HUK1可以增加缺血区域的血流量,促进急性缺血性脑梗死患者大脑侧支循环的建立,并可以显著改善患者的神经功能缺损程度及日常生活能力。
[Abstract]:Objective: to analyze the effect of human urine kallikreinhk UK 1 on hemodynamics and nerve function in patients with acute ischemic cerebral infarction by CT perfusion imaging. Methods: 69 patients with acute cerebral infarction were selected. The control group was given basic antiplatelet therapy (aspirin 0.1 g / d, clopidogrel 75 mg / d). CTP was performed before and after 3 weeks of treatment. The CTP parameters (relative cerebral blood flow r CBF, relative cerebral blood volume r CBV and relative peak time r TTP) were observed, and the NIHSS scores of the patients within 24 hours of admission and 3 weeks after treatment were recorded. Results: compared with the control group, the indexes of the penumbra of infarct focus in the observation group after 3 weeks of treatment were better than those in the control group (r CBF(0.84 卤0.17 r CBV(0.89 卤0.25) and r TTP(1.29 卤0.37). There was significant difference in perfusion parameters (P 0.05 卤5.69), which was better than that before treatment (11.71 卤5.62) and the control group (4.98 卤5.04) (P 0.01), and the follow-up mRS score (1.58 卤1.77) was better than that of the control group (2.36 卤1.52P0.050.Conclusion: HUK1 can increase blood flow in ischemic area. Promote the establishment of cerebral collateral circulation in patients with acute ischemic cerebral infarction, and can significantly improve the degree of neurological deficit and the ability of daily living.
【作者单位】：湖北医药学院附属襄阳医院神经内科;湖北医药学院附属襄阳医院放射科;
【基金】：襄阳市科技计划研究与开发项目(襄科业〔2012〕41号;襄科业〔2014〕11号) 湖北省教育厅科技研发项目(B2015483)
【分类号】：R743.33

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