目的 探讨人尿激肽原酶治疗进展性前循环与后循环脑梗死的疗效.方法 按英国牛津郡卒中研究分型(OSCP)将33例进展性脑梗死患者分为前循环梗死组(22例)和后循环梗死组(11例).给两组患者用人尿激肽原酶(尤瑞克林)0.15 U/d静脉滴注,连续14 d.在治疗前、后给患者进行美国国立卫生研究院卒中量表(NIHSS)和日常生活活动(ADL)量表评分,并根据评分的变化评定患者的疗效.结果 治疗后,前循环梗死组和后循环梗死组患者的NIHSS评分均比治疗前明显降低,ADL评分明显升高(均P<0.05);并且前循环梗死组的NIHSS评分明显低于、ADL量表评分明显高于后循环梗死组(均P<0.05).前循环梗死组治疗前、后ADL量表评分的差值(8.69±2.76)明显大于后循环梗死组(5.01±1.99) (P<0.01).前循环梗死组的总有效率和显效率(81.8%,36.4%)明显高于后循环梗死组(54.5%,9.1%)(均P <0.01).结论 人尿激肽原酶治疗进展性前循环脑梗死的临床疗效明显优于进展性后循环脑梗死.
Objective To explore the curative effects of urinary Kallidinogenase on progresive anterior circulation and posterior circulation cerebral infarction.Methods Thirty-three patients with progressing cerebral stroke were classified into anterior circulation infarction group (ACI group,22 cases) and posterior circulation infarction group (PCI group,11 cases) according to Oxfordshire community stoke project (OSCP).Both groups were injected with urinary Kallidinogenase 0.15 U/d for 14 d.The national institutes of health stroke scale (NIHSS) and activity of daily living scale (ADL) were scored before and after treatment,and which was used to evaluate the curative effects.Results The NIHSS scores of ACI group and PCI group were decreased and the ADL scores were increased after treatment (all P < 0.05).Meanwhile,the NIHSS scores of ACI group was lower while the ADL score was higher than PCI group (all P < 0.05).The difference value of ADL in ACI group (8.69 ± 2.76) was greater than that in PCI group (5.01 ± 1.99)(P<0.01).The total effective rate and significant efficiency in ACI group (81.8%,36.4%) were significantly higher than that in PCI group (54.5%,9.1%) (all P <0.01).Conclusion The curative effects of urinary kallidinogenase on treating progressing ischemic stroke with anterior circulation infarction is much better than posterior circulation infraction.