9.应用磁共振技术观察人尿激肽原酶对急性脑梗死患者脑血流灌注的影响 (2)

and after the treatment in the urinary kallidinogenase and Danshen group s, and there were significant differ2 ences ( P = 0. 037). The efficacy was better in patients w ith severe cerebral infarction in the urinary kal2 lidinogenase group. ② The ratio of increased volume of cerebral infarction were 42. 9% ( 9 /21 ) and 4112% ( 7 /17 ) respectively in the urinary kallidinogenase and Danshen group s, and there was also no significant difference (χ2 = 0. 01, P = 0. 92 ) ; the rate of p lasma exudation were 38. 1% ( 8 /21 ) and 1118% (2 /17) respectively in both group s, and there was also no significant difference ( P = 0. 14 ). ③Regional cerebral blood flow ( rCBF) in the infarcted area after the treatment in the urinary kallidinoge2 nase and Danshen group s were increased as compared w ith that before treatment, and there was significant difference ( P < 0. 001). The relative rCBF ( cerebral blood volume in the infarcted area / cerebral blood volume in the m irror image area) after the treatment in the urinary kallidinogenase group was increased re2 markably as compared with that after the treatment in the Danshen group (1. 26 ±0. 13 and 1. 05 ±0. 26, respectively) , and there was significant difference ( t = 2. 18, P < 0. 05). ④The recanalization rate in the patients of both group s were 71. 4% and 50. 0% respectively, and there was no significant difference ( P = 0. 59). Conclusion U rinary kallidinogenase may increase regional blood supp ly in infarcted areas in pa2 tients w ith acute cerebral infarction and effectively imp rove the neurological deficit of patients. It efficacy is more remarkable in the urinary kallidinogenase group than that in the Danshen group in patients with mod2 erate and severe cerebral infarction.
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中国脑血管病杂志 2009年 3月 18日第 6卷第 3期 Chin J Cerebrovasc D is,Mar118, 2009, Vol16, No13
应用磁共振技术观察人尿激肽原酶对 急性脑梗死患者脑血流灌注的影响
·临床研究 ·
百度文库
徐恩 缪学琼 林清原 潘英 钟高贤 刘克 谢海峰 詹丽璇
Abstract: O bjectives To observe the effect of human urinary kallidinogenase on the size of cerebral infarction and the cerebral blood flow by using magnetic resonance technology and to elucidate the possible mechanism of the agent. M ethods A total of 41 patients w ith acute cerebral infarction w ithin 48 hours of onset were enrolled and were random ized into urinary kallidinogenase group ( n = 23 ) and Danshen group ( n = 18). The patients were divided into m ild, moderate and severe cerebral infarction according to the National Institute of Health Stroke Scale (N IHSS). The urinary kallidinogenase group received urinary kallidinogenase 0. 15 PNA unit, and the Danshen group received Danshen 400 mg, both agents were intra2 venously infused, once a day, 10 days as a course. A ll patients were observed with MR I ( including T1W I, T2W I, T2FLA IR , MRA , DW I and PW I sequences) before and 10 days after the treatment. The clinical p rognosis of the patients was assessed w ith the modified Rankin scale at 30 and 90 days after the onset of symp tom s. Results ①The N IHSS scores in both group s after the treatment were lower than those before the treatment ( P < 0. 01). In patients w ith moderate and severe cerebral infarction whose N IHSS was > 10, their N IHSS median difference scores were 4. 0 (3. 0 - 7. 0) and 2. 0 (2. 0 - 3. 0) respectively before
摘要 : 目的 应用磁共振技术观察人尿激肽原酶 (尤瑞克林 )对急性脑梗死患者脑梗死灶大 小 、脑血流等的影响 ,进一步阐明药物的可能作用机制 。 方法 选取发病 48 h内的急性脑梗死患 者 41例 ,随机分为尤瑞克林组 (23例 )和丹参组 (18例 ) 。根据美国国立卫生院卒中量表 (N IHSS) , 将患者分成轻 、中 、重三度 。尤瑞克林组 ,给予 0. 15 PNA 单位尤瑞克林 ,丹参组给予 400 mg丹参 ,均 为静脉滴注 , 1次 / d, 10 d为一疗程 。于治疗前及治疗后 10 d对患者进行头部磁共振多序列的检查 。 发病后 30 、90 d采用改良 Rankin量表评定患者的临床预后 。 结果 ①两组治疗后 N IHSS分值 ,均 较治疗前降低 ( P < 0. 01) ; N IHSS > 10的中 、重度患者 ,尤瑞克林组 、丹参组治疗前后 N IHSS差值中 位数分别为 4. 0 (3. 0～7. 0) , 2. 0 (2. 0～3. 0) ,差异有统计学意义 ( P = 0. 037) ,尤瑞克林组对中 、重 度患者疗效更好 ; ②尤瑞克林组 、丹参组梗死灶增大的比率分别为 42. 9% ( 9 /21)和 41. 2% ( 7 /17) , 差异无统计学意义 ( P = 0. 92) ,两组梗死灶渗血率分别为 38. 1% (8 /21)和 11. 8% ( 2 /17) ,差异无统 计学意义 ( P = 0. 14) ; ③尤瑞克林组及丹参组在治疗后 ,梗死区局部脑血流量均较治疗前增加 ,差异有 统计学意义 ( P < 0. 001) ;尤瑞克林组在治疗后相对局部脑血流量 (梗死区脑血容量 /镜像区脑血容量 ) 增加较丹参组明显 ,分别为 1. 26 ±0. 13和 1105 ±0. 26,差异有统计学意义 ( t = 2. 18, P < 0105) ; ④MRA 显示两组患者的大血管再通比例分别为 5 /7和 3 /6,差异无统计学意义 ( P = 0. 59) 。 结论 尤瑞克 林能增加急性脑梗死患者的梗死区血液供应 ;与丹参组比较对中 、重度患者疗效更好 。
关键词 : 激肽释放酶类 ;脑梗死 ;磁共振成像 ;局部血流 do i: 1013969 / j1issn1167225921120091031003 中图分类号 : R743; R445. 2 文献标识码 : A
Effect of human ur inary ka llid inogena se on bra in perfusion observed by magnetic resonance tech2 nology in pa tien ts w ith acute cerebra l infarction XU En, M IAO X ue2qiong, L IN Q ing2yuan, PAN Y ing, ZHON G Gao2x ian, L IU Ke, X IE Ha i2feng, ZHAN L i2xuan. D epa rtm en t of N eu rology, the S econd A f2 filia ted Hospita l of Guangzhou M ed ica l College, Guangzhou 510260, Ch ina
基金项目 :广东省科技攻关项目 (2006B36007002) ;广州市科技攻关项目 (2006z12e0115) 作者单位 : 510260 广州医学院第二附属医院神经内科 (徐恩 、缪学琼 、林清原 、潘英 、钟高贤 、谢海峰 、詹丽璇 ) ,
放射科 (刘克 )
中国脑血管病杂志 2009年 3月 18日第 6卷第 3期 Chin J Cerebrovasc D is,Mar118, 2009, Vol16, No13
Key words: Kallikrein; B rain infarction; M agnetic resonance imaging; Regional blood flow