症状性脑动脉狭窄未行支架植入患者纤维蛋白原调治研究  

Study on the fibrinogen regulation and treatment in patients with symptomatic cerebral artery stenosis without stent implantation

作　　者：王连芹 刘海花 王玉 彭红兵 李俊青 王云 宁海春 

机构地区：[1]河北省邢台市第三医院脑血管病治疗中心,054000

出　　处：《河北医药》2012年第1期11-13,共3页Hebei Medical Journal

基　　金：河北省科学技术研究与发展计划项目(编号:10276105D-30)

摘　　要：目的探索症状性脑动脉狭窄未行支架植入患者理想Fib调治目标值。方法初发症状性脑动脉狭窄患者1126例,随机分为治疗组787例,对照组339例。治疗组患者发病急性期选用注射用纤溶酶将纤维蛋白原(Fib)维持在2.0～2.4g/L;30d后应用复方丹参滴丸将Fib维持在2.5～2.9g/L,并长期维持达标。在长期二级预防中,根据Fib水平值进行调治;对照组方法同治疗组,将Fib维持在1.3g/L以下水平。比较2组治疗后3年和5年健康功能水平、终点事件、不良反应、依从性情况。结果治疗组3年和5年心脏事件、脑梗死发生和复发率及各种出血性不良反应均低于对照组(P<0.01);肝酶升高治疗组低于对照组(P<0.05),治疗组3年和5年健康功能水平均高于对照组(P<0.05),治疗后5年病死率低于对照组(P<0.05)。对照组退出率高于治疗组(P<0.05)。结论脑动脉狭窄未行支架植入患者发病急性期将Fib维持在2.0～2.4g/L、30d后将Fib维持在2.5～2.9g/L,二级预防中根据Fib水平值进行调治,疗效显著、安全、患者依从好。Objective To explore ideal fibrinogen target value in patients with symptomatic cerebral artery stenosis without stent implantation. Methods The 1126 patients with symptomatic cerebral artery stenosis were randomly divided into treatment group （ n =787） and control group（ n =339）. The patients at acute period in treatment group were treated by using fibrinogenase for injection to keep fibrinogen （Fib） at 2.0 - 2.4g/L, after 30 days, who were treated by application of compound Danshen dropping pill, with Fib levels being kept at 2.5 2. gg/L. During the long-term secondary prevention, the patients were treated according to their Fib levels. The patients in control group were treated by the same method as that of treatment group, but Fib levels were maintained under 1.3g/L. The health functional levels, endpoint event, adverse reactions and compliance after 3 years and 5 years were compared between the two groups. Results After 3 years and 5 years the incidences of cardiac events and cerebral infarction recurrence in treatment group were significantly lower than those in control group （ P 〈 0. 01 ）,furthermore,the adverse reactions in treatment group were significantly lower than those in control group （ P 〈0. 01 ）. The liver enzyme levels in treatment group were obviously lower than those in control group （ P 〈 0. 05 ） ,however, the health functional levels after 3-year and 5-year in treatment group were significantly higher than those in control group （ P 〈0. O1 ）. The fatality rate after 5 years was significantly lower than that in control group （ P 〈 0.01 ）, however, the withdraw rate in control group was significantly higher than that in treatment group （ P 〈 O. 05 ）. Conclusion For the patients with symptomatic cerebral artery stenosis without stent implantation, their Fid levels are kept at 2.0 - 2.4g/L, after 30 days, at 2.5 - 2.9g/L, they are treated according to Fib levels during the long-term secondary prevention, and the therapeutic effect is effective ,wit

关 键 词：脑动脉狭窄 纤维蛋白原 调治 预后 患者依从 

分 类 号：R743.1[医药卫生—神经病学与精神病学]