人纤维蛋白原联合依达拉奉治疗急性脑梗死静脉溶栓后出血转化伴凝血障碍观察  

Observation of Human Fibrinogen Combined with Edaravone in the Treatment of Acute Cerebral Infarction with Hemorrhagic Transformation and Coagulation Disorder after Intravenous Thrombolysis

作　　者：黄鹏 唐川 曾凡波 Huang Peng;Tang Chuan;Zeng Fanbo(Department of Neurology,Dujiangyan People's Hospital(Dujiangyan Medical Center),Si-chuan Dujiangyan 611830,China)

机构地区：[1]都江堰市人民医院(都江堰市医疗中心)神经内科,四川都江堰611830

出　　处：《中国药师》2022年第5期832-836,共5页China Pharmacist

摘　　要：目的:观察人纤维蛋白原联合依达拉奉治疗急性脑梗死静脉溶栓后出血转化伴凝血障碍的效果。方法:110例急性脑梗死静脉溶栓后出血转化伴凝血障碍患者数字表法分为两组(对照组和观察组)各55例,入组后均停用抗栓或溶栓药物,给予降颅压、降血压等对症支持治疗。对照组给予冻干人纤维蛋白原1~2 g治疗,观察组在对照组基础上加用依达拉奉30 mg,ivd,bid。持续治疗14 d后,观察两组治疗前后凝血功能、神经缺损程度、氧化应激指标的变化,以及遗留残疾程度和不良反应差异。结果:治疗后,两组凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)等均较治疗前缩短(P<0.05);美国国立研究院脑卒中评定量表(NIHSS)评分、改良RANKIN量表(MRS评分)评分、血清丙二醛(MDA)、晚期氧化蛋白产物(AOPP)水平等指标均较治疗前降低(P<0.05),血清超氧化物歧化酶(SOD)、总抗氧化能力(T⁃AOC)水平、纤维蛋白原水平等则较治疗前增高(P<0.05)。且除凝血功能指标外,观察组上述其他指标均明显优于对照组(P<0.05)。两组治疗过程中未观察到血栓栓塞事件发生,不良反应发生率比较差异无统计学意义(P>0.05)。结论:人纤维蛋白原联合依达拉奉可纠正凝血功能紊乱,抑制氧化应激反应,减轻神经功能损伤和遗留残疾程度,治疗急性脑梗死静脉溶栓后出血转化伴凝血障碍效果优于人纤维蛋白原治疗。Objective:To observe the effects of human fibrinogen combined with edaravone in the treatment of acute cerebral in⁃farction with hemorrhagic transformation and coagulation disorder after intravenous thrombolysis.Methods:Totally 110 cases of acute cerebral infarction patients with hemorrhagic transformation and coagulation disorders after intravenous thrombolysis were divided into two groups(control group and observation group)with 55 cases in each group.After enrollment,antithrombotic and thrombolytic drugs were both stopped,and symptomatic and supportive treatments such as lowering intracranial pressure and lowering blood pressure were given.The control group was treated with freeze⁃dried human fibrinogen 1⁃2 g,and the observation group was additionally treated with edaravone 30 mg,ivd,bid on the basis of the control group.After 14 days of continuous treatment,the changes of coagulation function,degree of neurological deficit,oxidative stress indexes,degree of residual disability and adverse reactions were observed between the two groups before and after treatment.Results:After treatment,the thrombin time(TT),prothrombin time(PT)and activated partial thromboplastin time(APTT)in the two groups were all shortened compared with those before treatment(P<0.05).(NIHSS)score,modified RANKIN scale(MRS score)score,serum malondialdehyde(MDA),advanced oxidation protein product(AOPP)levels and other indicators were all lower than those before treatment(P<0.05).Serum superoxide dismutase(SOD),total antioxidant capacity(T⁃AOC)and fibrinogen levels were higher than those before treatment(P<0.05).Except the coagulation function indexes,the above indexes in the observation group were significantly better than those in the control group(P<0.05).No thromboembolic event was found in the two groups during the treatment,and there was no significant difference in the incidence of adverse reactions(P>0.05).Con⁃clusion:Human fibrinogen combined with edaravone can correct coagulation disorders,inhibit oxidative stress,reduce ne

关 键 词：急性脑梗死 静脉溶栓 出血转化 人纤维蛋白原 依达拉奉 

分 类 号：R973.1[医药卫生—药品]