巴曲酶与蚓激酶序贯疗法治疗急性脑梗死  

Sequential defibrase for acute cerebral infarction by batroxobin and lumbrukinase

作　　者：谢江文[1] 赵菊芳[1] 颜政[1] 毛玲群[1] 闻绍云[1] 王云玲[1] 杨俊彦[1] 黄睿[1] 

机构地区：[1]上海瑞金医院集团台州市中心医院神经内科,浙江省台州318000

出　　处：《中国基层医药》2007年第3期419-421,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的通过对三种不同降纤方案的比较，探索经济有效的降纤治疗方案。方法连续累积该院2004年10月至2005年8月急性脑梗死住院患者，随机分为蚓激酶组（A组）35例、巴曲酶组（B组）40例和两药序贯疗法组（C组）50例，均于发病后6～72h内给药。治疗方法：A组入院当天起日服蚓激酶胶囊60万U，每天3次，共14d；B组自入院当天起隔日给予巴曲酶治疗；C组入院时给予巴曲酶10U治疗1次，同时口服蚓激酶胶囊60万U，每天3次，共14d。评价治疗前后各组神经功能缺损程度及变化时间，比较三组治疗后实验室指标、医疗费用。结果（1）治疗半个月时显效率与痊愈率，C组显著高于A组，B组与C组差异无统计学意义。（2）神经功能缺损评分，A组在（2．8±0．9）d开始降低，B组与C组则在1d内开始降低。（3）治疗后血液流变学各项指标的变化，A组不如B、C组明显，而B组和C组间则无明显差异。（4）A组与C组均出现轻度的胃肠道不适，B组中有2例75岁以上患者在症状改善后再次加重，其中1例CT检查证实为出血性脑梗死。（5）费用上，三组从低到高依次为A组、C组、B组。结论蚓激酶与巴曲酶序贯疗法治疗急性脑梗死是一种经济安全的降纤方法。Objective To explore an economic effect therapeutic regimen for acute cerebral infarction（ACI） by compared the effect with three different difibrase project. Methods Totally 125 inpatients with ACI were consecutively selected from the department of neurology, central Hospital of Taizhou, Ruijin hospital group, between October 2004 and Augest 2005. The patients were individed three groups at random, A group of 35 patients treated with batroxobin,B group of 40 patients treated with lumbrukinase, and C group of 50 patients sequentially treated with batroxobin and lumbrukinase. All patients were treated from 6 to 72 hours when they onseted. A group took lumbrukinas caps orally 600000U, rid,every other day in 14 days. B group took batroxobin orally every other day. C group took batroxobin only time on admission,and took lumbrukinase caps 600000U, rid,in 14 days. Treatment results between pretherapy and post-treatment depended on changes of the degree of neurologic impairment. The curative effect, medical cost and length of stay were analyzed among three groups treated respectively. Results （ 1 ） The rate of excellence and recovery in C group was significantly increased than in A group, and there were no significance between B group and C group. （2）The degree of neurologic impairment began to decrease in （2.8 ± 0.9） days in A group,but only one day in B group or C group. （3）The variances of hemorrheology was less obvious in A group than B or C group,but there were not significant difference between B group and C group. （4）There were low-grade gastrointestinal tract indisposition in every patient of A group and C group. Contrary, there were two cases older than 75 years in the B group got worse sooner after improving, one of the two was verificated hemorrhagic infarct by CT. （5） The health care cost increased from A group to C group. Conclusion Sequential defibrase for acute cerebral infarction by batroxobin and lumbrukinase is an economic effect therapeutic regimen.

关 键 词：脑梗死 蚓激酶 巴曲酶 

分 类 号：R74[医药卫生—神经病学与精神病学]