目的 研究小牛血清去蛋白聯(lián)合組織型纖溶酶原激活劑治療腦梗死的療效。方法 選擇2014年3月-2015年3月唐山康復(fù)醫(yī)療中心收治的腦梗死患者120例,隨機(jī)分成對照組和治療組,每組各60例。對照組患者給予重組組織型纖溶酶原激活劑注射粉劑,溶于無菌注射用水中,取其中的10%進(jìn)行靜脈注射,剩余的90%應(yīng)在50min內(nèi)及時進(jìn)行靜脈滴注,使用劑量為0.6mg/kg(最大劑量≤50mg);治療組在對照組的基礎(chǔ)上靜脈滴注小牛血清去蛋白注射液,30mL溶于250mL生理鹽水,1次/d。兩組患者均連續(xù)治療2周。觀察兩組的臨床療效,比較兩組治療前后神經(jīng)功能缺損(NHISS)評分、簡易智能精神狀態(tài)量表(MMSE)和血液流變學(xué)指標(biāo)。結(jié)果 治療后,對照組和治療組總有效率分別為63.3%、78.3%,兩組總有效率比較差異具有統(tǒng)計學(xué)意義(P<0.05)。治療后,兩組患者NIHSS評分較治療前明顯下降,MMSE較治療前明顯升高,同組治療前后差異有統(tǒng)計學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)的改善程度優(yōu)于對照組,兩組比較差異有統(tǒng)計學(xué)意義(P<0.05)。兩組患者的血漿比黏度和血小板聚集率均顯著降低,同組治療前后差異有統(tǒng)計學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)的降低程度優(yōu)于對照組,兩組比較差異有統(tǒng)計學(xué)意義(P<0.05)。結(jié)論 小牛血清去蛋白聯(lián)合組織型纖溶酶原激活劑治療腦梗死具有良好的療效,能夠顯著降低NIHSS評分,明顯升高M(jìn)MSE,并能明顯改善患者的血液流變學(xué)指標(biāo),具有一定的臨床推廣應(yīng)用價值。

Objective To study the clinical effect of deproteinized calf blood serum combined with tissue plasminogen activator in treatment of cerebral infarction. Methods Patients (120 cases) with cerebral infarction in Tangshan Rehabilitation Medical Center from March 2014 to March 2015 were selected. The patients were randomly divided into control group and treatment group, and each group had 60 cases. Patients in the control group were given Tissue Plasminogen Activator Injection, dissolving in sterile water for injection, 10% for iv injection, and the other 90% within 50 min for iv drip. The using dose was 0.6 mg/kg, and the maximum dose was ≤ 50 mg. Patients in the treatment group were given Deproteinised Calf Blood Serum Injection by iv drip, 30 mL added into normal saline 250 mL, once daily. After treatment, the clinical efficacies were evaluated, and NIHSS score, MMSE, and hemorheological indexes before and after treatment in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 63.3% and 78.3%, respectively, and there were differences between two groups (P < 0.05). After treatment, NIHSS scores in two groups were significantly decreased, but MMSE were significantly increased, and the differences were statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, and there were significant differences between two groups (P < 0.05). After treatment, the ratio of viscosity and platelet aggregation rate were significantly decreased, and the differences were statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Deproteinized calf blood serum combined with tissue plasminogen activator has clinical curative effect in treatment of acute progressing cerebral infarction, and can significantly reduce NIHSS scores, increase MMSE, obviously improve hemorheological indexes, which has a certain clinical application value.