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目的:观察灯盏花素辅助治疗对急性脑梗死患者血液流变学、血管内皮功能及凝血功能的影响。方法:选择本院确诊为急性脑梗死的患者共144例,包括观察组和对照组各72例,对照组采用常规对症治疗,观察组在对照组基础上加用灯盏花素静脉滴注辅助治疗,比较两组患者治疗前后血液流变学、血管内皮功能及凝血功能的差异。结果:经治疗后,观察组NIHSS评分(3.01±1.40)显著低于对照组(3.96±2.17),观察组总有效率显著高于对照组(94.4%vs.86.1%,P<0.05)。两组间治疗前各指标水平差异未发现统计学意义(P>0.05);两组治疗后全血黏度(whole blood viscosity,WBV)、全血还原黏度(whole blood reduced viscosity,WBRV)、血浆粘度(plasma viscosity,PV)和红细胞聚集指数(erythrocyte aggregation index,EAI)均显著降低(P<0.05);其中观察组各个指标均显著低于对照组(P<0.05);两组治疗后血管内皮素-1(endothelin-1,ET-1)水平与循环内皮细胞(circulating endothelial cell,CEC)计数显著降低,而一氧化氮(nitrie oxide,NO)及可溶性血栓调节蛋白(soluble thrombomodulin,s TM)水平显著升高(P<0.05),其中观察组ET-1水平显著低于对照组,而NO及sTM水平显著高于对照组(P<0.05);两组治疗后凝血酶原时间(prothrombin time,PT)及部分活化凝血酶原时间(activated partial thromboplastion time,APTT)显著升高,纤维蛋白原(fibrinogen,Fib)和D-二聚体(D-dimer,DD)显著降低(P<0.05);其中观察组PT和APTT显著高于对照组,DD显著低于对照组(P<0.05)。结论:灯盏花素辅助治疗能有效改善急性脑梗死患者血液粘稠状态,保护血管内皮功能及改善凝血功能。
Objective: To observe the effects of breviscapine adjuvant therapy on hemorrheology, endothelial function and coagulation function in patients with acute cerebral infarction. Methods: A total of 144 patients with acute cerebral infarction in our hospital were selected, including 72 cases in observation group and control group. Conventional symptomatic treatment was used in control group. Breviscapine intravenous infusion assisted therapy was used in observation group on the basis of control group The differences of hemorheology, vascular endothelial function and coagulation function between the two groups before and after treatment were compared. Results: After treatment, the NIHSS score in the observation group (3.01 ± 1.40) was significantly lower than that in the control group (3.96 ± 2.17). The total effective rate in the observation group was significantly higher than that in the control group (94.4% vs 86.1%, P <0.05). There was no significant difference between the two groups before treatment (P> 0.05). After treatment, the values of whole blood viscosity (WBV), whole blood reduced viscosity (WBRV), plasma viscosity (P <0.05). The indexes of plasma viscosity (PV) and erythrocyte aggregation index (EAI) of the two groups were significantly lower than those of the control group (P <0.05) (ET-1) and circulating endothelial cells (CEC) were significantly decreased, while the levels of nitric oxide (NO) and soluble thrombomodulin (s TM) (P <0.05). ET-1 level in the observation group was significantly lower than that in the control group, but NO and sTM levels were significantly higher than those in the control group (P <0.05). Prothrombin time PT and APTT were significantly increased, and fibrinogen (Fib) and D-dimer (DD) were significantly decreased (P <0.05); The observation group PT and APTT were significantly higher than the control group, DD was significantly lower than the control group (P < 0.05). Conclusion: Breviscapine adjuvant therapy can effectively improve blood viscosity in patients with acute cerebral infarction, protect vascular endothelial function and improve coagulation function.