重组活化凝血因子rFⅦa对脑出血早期血肿再扩大的干预研究  

Intervention study on recombinant activated factor Ⅶa in depressing early hematoma extensions of cerebral hemorrhage

作　　者：李欣[1] 王雅琼[1] 李雯[1] 

机构地区：[1]上海市杨浦区中心医院神经内科,上海200090

出　　处：《中国新药杂志》2012年第2期161-163,216,共4页Chinese Journal of New Drugs

摘　　要：目的:探讨重组活化凝血因子(rFⅦa)在脑出血早期血肿再扩大中的临床价值。方法:选择发病6 h内完成头颅CT的64例脑出血患者,随机分为rFⅦa治疗组(rFⅦa组)和未应用rFⅦa组(对照组),rFⅦa组给予40μg.kg-1 rFⅦa静脉推注治疗,对照组常规治疗。两组患者分别在治疗前、治疗24 h后比较血肿变化,同时行格拉斯哥昏迷量表(GCS)评分和美国国立卫生研究院卒中量表(NIHSS)评分,3个月后改良的Rankin量表(mRS)评分以评价转归。结果:24 h后复查头颅CT时rFⅦa组血肿扩大(>33%)4例(12.5%),对照组血肿扩大11例(34.4%),两组比较有显著差异(P<0.05);24 h后rFⅦa组GCS评分较对照组增加(P<0.05),NIHSS评分却明显低于对照组(P<0.05);3个月后两组mRS评分在0～3分的患者所占该组比率分别为84%和59%,两组差异有统计学意义。临床未见有不良反应发生。结论:rFⅦa对于脑出血早期血肿扩大具有明显的抑制作用。Obejective：To explore the clinical value of recombinant activated factor Ⅶa（rFⅦa） in depressing early hematoma extensions of cerebral hemorrhage.Methods： Sixty-four patients with cerebral hemorrhage which were imaged with CT within 6 hours after symptom onset were divided into therapy group（rFⅦa group） and control group randomly.The patients in therapy group were treated with intravenous rFⅦa 40 μg·kg-1,and those in control group received conventional therapy.The two groups were compared in hematoma size variation,GCS and NIHSS scores at pre-therapy and 24 hours after therapy,and mRS score at 3 months after onset.Results： All patients undertook CT check over 24 hours after onset.Four patients（12.5%） and 11 patients（34.4%） in the therapy and control group showed hematoma increment greater than 33%,respectively（P0.05）.Twenty-four hours after therapy,the GCS scores of therapy group were higher than those of control group（P0.05）,while the NIHSS scores of therapy group were lower than those of control group（P0.05）.Evaluation with mRS scores between 0~3 3 months after onset showed the efficacy rates were 84% and 59% for the therapy and control group respectively.No adverse reactions occurred clinically.Conclusion： rFⅦa can depress the expansion of the hematoma in early cerebral hemorrhage.

关 键 词：重组活化凝血因子Ⅶa 脑出血 早期血肿扩大 

分 类 号：R743.34[医药卫生—神经病学与精神病学]