纤溶酶联合丹红注射液溶栓疗法对缺血性脑血管病患者脑血流量和血清Hcy、S-100β水平的影响  

Therapeutic effects of combined thrombolytic therapy with plasmin and Danhong injection on ischemic cerebrovascular disease and the influence on cerebral blood flow and serum Hcy and S-100βlevels

作　　者：吕凤琼[1] 唐春梅[1] 周瑶[1] 付彩雯[2] LYU Fengqiong;TANG Chunmei;ZHOU Yao;FU Caiwen(Department of General Medicine,Suining Central Hospital,Suining 629000,Sichuan,China;Department of Endocrinology,Suining Central Hospital,Suining 629000,Sichuan,China)

机构地区：[1]遂宁市中心医院全科医学科,四川遂宁629000 [2]遂宁市中心医院内分泌科,四川遂宁629000

出　　处：《贵州医科大学学报》2023年第5期597-602,共6页Journal of Guizhou Medical University

基　　金：四川省中医药管理局科学技术研究专项课题(2020LC0215)。

摘　　要：目的纤溶酶联合丹红注射液溶栓疗法对缺血性脑血管病(ICVD)患者的疗效及对脑血流量和血清同型半胱氨酸(Hcy)、中枢神经特异蛋白(S-100β)水平的影响。方法将102例ICVD患者均分为观察组(n=51)及对照组(n=51),两组患者均给予抗血小板聚集、稳定斑块、降压、降糖等基础治疗,对照组患者给予丹红注射液治疗,观察组给予纤溶酶联合丹红注射液治疗;于治疗2周时,比较2组的治疗效果,治疗前后的脑血流灌注指标[平均流速(Vm)、峰流速(Vp)、脑血管阻力(CVR)、脉动指数(PI)]、检测血清中脑损伤指标[中枢神经特异蛋白(S-100β)、血清同型半胱氨酸(Hcy)、丙二醛(MDA)、特异性烯醇化酶(NSE)、脑源性神经营养因子(BDNF)];比较2组患者治疗前及治疗1周时的血液流变学指标(纤维蛋白原、低切全血黏度、红细胞压积、高切全血黏度、血浆黏度)及血清C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子(TNF-α)、单核细胞趋化蛋白(MCP-1)水平。结果治疗2周时,观察组患者疗效优于对照组,差异有统计学意义(P<0.05);治疗2周时,2组患者的Vm、Vp、CVR均高于治疗前,PI低于治疗前,观察组变化更显著,差异有统计学意义(P<0.05);治疗2周时,2组患者血清S-100β、Hcy、MDA、NSE均低于治疗前,BDNF高于治疗前,观察组变化更显著,差异有统计学意义(P<0.05);治疗1周时,2组患者血液高切全血黏度、低切全血黏度、血浆黏度、红细胞压积、纤维蛋白原水平及血清CRP、IL-6、TNF-α及MCP-1水平均较治疗前降低,观察组变化更显著,差异有统计学意义(P<0.05)。结论纤溶酶联合丹红注射液治疗可有效改善ICVD患者脑血流灌注,其机制可能与改变血液黏度、降低机体炎症反应有关。Objective To investigate the therapeutic effects of combined thrombolytic therapy with plasmin and Danhong injection on ischemic cerebrovascular disease(ICVD),and the influence on cerebral blood flow and serum homocysteine(Hcy)and central nervous system specific protein(S-100β)levels.Methods A total of 102 patients with ICVD were divided into the observation group(n=51)and the control group(n=51).All patients were given basic treatments such as anti-platelet aggregation treatment,treatment for stabilizing plaque,treatment for lowering blood pressure and glucose.On this basis,patients in the control group were treated with Danhong injection,and those in the observation group were treated with plasmin on the basis of the treatment of control group.The two groups were compared in terms of the efficacy after 2 weeks of treatment,cerebral blood flow perfusion indicators[mean velocity(Vm),peak velocity(Vp),cerebrovascular resistance(CVR),and pulsatility index(PI)]and serum brain injury indicators[S-100β,Hcy,malondialdehyde(MDA),neuron-specific enolase(NSE),and brain derived neurotrophic factor(BDNF)]before treatment and after 2 weeks of treatment,serum inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor(TNF-α),and monocyte chemoattractant protein(MCP-1)]after 2 weeks of treatment,and changes in hemorheological indicators(fibrinogen,whole blood low shear viscosity,hematocrit,whole blood high shear viscosity and plasma viscosity)after 1 week of treatment.Results After 2 weeks of treatment,curative effect in the observation group was better than that in the control group(P<0.05).After 2 weeks of treatment,Vm,Vp,and CVR increased,and PI decreased in the two groups.The changes in the observation group were more significant than those in the control group(P<0.05).After treatment,S-100β,Hcy,MDA,and NSE decreased,and BDNF increased in the two groups.The changes in the observation group were more significant than those in the control group(P<0.05).Hemorheological indicators after 2 weeks o

关 键 词：溶栓 丹红注射液 纤溶酶 缺血性脑血管病 疗效 脑血流量 同型半胱氨酸 中枢神经特异蛋白 

分 类 号：R743.3[医药卫生—神经病学与精神病学]