乌司他丁对后循环脑梗死患者的治疗作用  

Therapeutic effect of ulinastatin on posterior circulation cerebral infarction

作　　者：宋德刚[1] 陈晓雪[1] 

机构地区：[1]秦皇岛市第一医院,河北秦皇岛066000

出　　处：《武警后勤学院学报（医学版）》2015年第10期783-785,共3页Journal of Logistics University of PAP（Medical Sciences）

摘　　要：【目的】观察乌司他丁对后循环梗死患者的疗效。【方法】将63例后循环脑梗死患者随机分为治疗组(31例)和对照组(32例),对照组仅给予西医常规治疗,治疗组在对照组基础上于入院当日起静脉滴注乌司他丁200 k U/次,间隔8 h给予1次。分别于入院时(第1天)、第3天、第7天行头颅MRI检查测量脑梗死体积,行急性生理和慢性健康评分系统Ⅱ(acute physiology and chronic health evaluationⅡscore,APACHEⅡ)评分,同时检测两组患者的血清炎症因子白介素6(IL-6)及一氧化氮(NO)水平。【结果】入院时两组脑梗死体积、APACHEⅡ评分和血清IL-6、NO水平对比无差异(P>0.05)。入院第3天两组脑梗死体积及APACHEⅡ评分对比无差异(P>0.05),在第7天治疗组的脑梗死体积及APACHEⅡ评分明显小于对照组,差异具有统计学意义(P<0.05);治疗组入院第3、7天NO和IL-6含量明显低于对照组,差异有统计学意义(P<0.05)。【结论】乌司他丁能够抑制脑水肿进展,显著降低体内炎症因子水平,改善APACHEⅡ评分,对后循环脑梗死患者具有脑保护作用,有助于缓解病情。[ Objective ] To observe the therapeutic effect of ulinastatin on posterior circulation cerebral infarction. [ Methods ] A total of 63 patients with posterior circulation cerebral infarction were randomly divided into treatment group（n=31） and control group（n=32）. Cases in control group were treated conventionally with Western medicine while patients in treatment group received not only routine treatment but also intravenous drip infusion of ulinastatin 200 kU every 8 h from the first day of hospitalization. Cerebral infection volumes were mea- sured with MRI at the 1st, 3rd and 7th day of hospitalization and scored with APACHE Ⅱ. Levels of inflammatory mediators （IL-6 and NO） were determined at the same time. [Results] Before the treatment, there was no significant difference in cerebral infarction volume, APACHE Ⅱ scores and levels of IL-6 and NO between the two groups（P〉0.05）. Cerebral infarction volume and APACHE Ⅱ scores in treat- ment group were obviously smaller and less than those in control group（P〈0.05） at the 7th day after treatment, but there was no significant difference between the two groups at the 3rd day（P〉0.05）. The levels of IL-6 and NO in treatment group were lower than those in control group at the 3rd and 7th day after treatment （P〈0.05）. [ Conclusion ] The application of ulinastatin in posterior circulation cerebral infarc- tion can potentially protect the brain and alleviate patient＇s conditions by inhibiting ischemic cerebral edema, improving APACHE Ⅱ scores and reducin~ the release inflammatory mediators.

关 键 词：乌司他丁 后循环脑梗死 梗死体积 炎症因子 APACHE 11评分 

分 类 号：R741.05[医药卫生—神经病学与精神病学]