尤瑞克林對(duì)腦梗死患者神經(jīng)功能及血清基質(zhì)金屬蛋白酶9的影響The effect of Kallikrein on neurological function and serum matrix metalloproteinase-9 in patients with cerebral infarction

【摘要】目的 探討尤瑞克林對(duì)腦梗死患者神經(jīng)功能及MMP-9的影響。方法 選擇我院神經(jīng)內(nèi)科診治的急性腦梗死患者90例，隨機(jī)分為觀察組和對(duì)照組，在常規(guī)治療的基礎(chǔ)上，對(duì)照組患者應(yīng)用疏血通，觀察組患者尤瑞克林，治療周期2周。采用NIHSS評(píng)分及MRS評(píng)分評(píng)價(jià)患者神經(jīng)功能缺損程度，應(yīng)用ELISA法檢測(cè)血清MMP-9水平。結(jié)果 1.觀察組患者治療效果優(yōu)于對(duì)照組（P＜0.05）。2.兩組患者治療3月后NIHSS評(píng)分及MRS評(píng)分明顯降低（P＜0.05）。治療3月后，觀察組患者NIHSS評(píng)分及MRS評(píng)分降低程度均較對(duì)照組顯著（P＜0.05）。3.治療2周后兩組患者血清MMP-9水平、血粘度及紅細(xì)胞壓積均有改善，且觀察組患者較對(duì)照組改善明顯（P＜0.05）。結(jié)論 尤瑞克林可以顯著改善腦梗死患者神經(jīng)功能，明顯降低其血清MMP-9水平，，具有很高的臨床應(yīng)用價(jià)值。
【關(guān)鍵詞】尤瑞克林；神經(jīng)功能；MMP-9；療效 

[Abstract] Objective To investigate the effect of Kallikrein on neurological function and serum MMP-9 in patients with cerebral infarction. Methods 90 patients with acute cerebral infarction who were treated in our hospital were chosen, They were randomly divided into two groups, On the basis of conventional therapy，The control group were treated with Shuxuetong，the observation group were treated with Kallikrein, for 2 weeks. NIHSS score and MRS score were used to evaluate the neurologic impairment, serum MMP-9 levels were tested using ELISA assay. Results 1. the effect of the the observation group were better than the control (P <0.05). The NIHSS score and the MRS score were significantly reduced in both groups after 3 months treatment(P <0.05). 3 months after treatment, the decrease of NIHSS score and the MRS score of the observation group were significantly higher than the control (P <0.05).  3. 2 weeks after treatment, the serum MMP-9 levels、 blood viscosity and hematocrit were improved, and the improvement in the observation group were significantly than that of the control(P<0.05). Conclusion Kallikrein can significantly improve neurological function in patients with cerebral infarction, significantly decrease serum MMP-9 levels, it high clinical application value.
[Key words] Kallikrein; nerve function; MMP-9; effect

腦梗死是神經(jīng)內(nèi)科常見病，它發(fā)病急驟，部分病情危重，有很高的致殘和致死率，嚴(yán)重影響了患者的生命安全和生活質(zhì)量。及時(shí)、準(zhǔn)確的診斷和合理的治療對(duì)其預(yù)后十分重要。血清基質(zhì)金屬蛋白酶9(matrix metalloproteinase-9，MMP-9)在腦缺血后腦組織損傷中起重要作用。尤瑞克林可以通過對(duì)低分子量激肽原的作用等途徑改善腦組織的血液灌注，促進(jìn)缺血腦組織功能的恢復(fù)[1]，但目前關(guān)于其對(duì)患者M(jìn)MP-9水平影響情況的報(bào)道較少。本研究中，筆者通過回顧性分析90例急性腦梗死患者的臨床資料，探討尤瑞克林對(duì)腦梗死患者神經(jīng)功能及MMP-9的影響。

1 資料與方法

1.1一般資料 回顧性分析2009年10月至2010年10月間我院神經(jīng)內(nèi)科診治的90例急性腦梗死患者的臨床資料。納入條件：年齡50-70歲；患者均為首發(fā)急性腦梗塞，并經(jīng)顱腦MRI的DWI檢查，發(fā)現(xiàn)明確腦梗塞病灶；發(fā)病至用藥時(shí)間≤12小時(shí)；此前未長期口服阿司匹林，氯吡格雷等抗血小板聚集藥物；腦梗塞病變血管為大腦中動(dòng)脈及大腦后動(dòng)脈。排除條件：大面積腦梗塞；房顫、心梗等心臟疾��；血液系統(tǒng)疾患；嚴(yán)重肝功能、腎功能不全；精神病病史及家族史；尤瑞克林過敏史。應(yīng)用MR后處理工作站中的測(cè)量工具測(cè)量梗死體積，測(cè)量范圍不含周圍水腫區(qū)。

2.結(jié)果
3．討論 

綜上所述，尤瑞克林可以顯著改善腦梗死患者神經(jīng)功能，明顯降低其血清MMP-9水平，有較好的療效，具有很高的臨床應(yīng)用價(jià)值。

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