缺血性进展性脑卒中患者不同治疗方法对血液hs-CRP 和D-D 水平的影响

目的　探究缺血性进展性脑卒中患者不同治疗方法对血液超敏C 反应蛋白（hypersensitive C-reactive protein， hs-CRP）、D- 二聚体（D-Dimer，D-D）水平影响及临床研究。方法　选取河北省荣军医院收治的缺血性进展性脑卒 中(progressive ischemic stroke，PIS) 患者120 例，随机分为观察组及对照组。对照组患者采用西药治疗；观察组在对照 组基础上给予地龙承气汤口服治疗。分别于治疗前后检测两组患者hs-CRP 和D-D 表达水平及血液流变学；记录两组患 者美国国立卫生研究院卒中量表（NIH Stroke Scale,NIHSS）及中医症状积分，并对治疗后有效率进行比较。结果　观 察组治疗后hs-CRP 水平、D-D 水平、高切全血黏度、低切全血黏度、血浆黏度和红细胞比容分别为6.48±0. 71mg/ L，1.75±0.46μg/L，4.74±1.32mPa · s，21.51±0.96mPa · s，1.52±0.74mPa · s 和31.53%±1.33%，明显优于对照组 （8.57±1.21mg/L，2.33±1.02μg/L，5.66±1.43mPa · s，22.86±0.99mPa · s，1.68±1.22mPa · s 和33.71%±1.92%）, 差异具有统计学意义（t=2.851，2.978，2.874，2.374，2.452 和2.451，均P ＜ 0.05）；根据美国国立卫生研究院卒中 量表（NIH Stroke Scale，NIHSS）和中医证候评分，观察组治疗后有效率（8.99±0.3,7.01±0.16）显著优于对照组 （10.33±0.54,13.36±0.86），差异具有统计学意义（t=2.854，3.012，均P ＜ 0.05）；观察组治疗总有效率（90%）高 于对照组（70%），差异具有统计学意义（χ2=2.522，P ＜ 0.05）。结论　采用地龙联合西药可以在缺血性进展性脑卒 中的治疗中发挥中西联合优势，具有较好的临床疗效。

Effect of Different Treatment Methods on the Levels of hs-CRP and D-D in Patients with Progressive Ischemic Stroke

Objective　To investigate the effect of different treatment methods on the levels of hs-CRP(hypersensitive C-reactive protein) and D-D (D-Dimer)in patients with ischemic progressive stroke and its clinical study. Methods　120 patients with ischemic progressive stroke (progressive ischemic stroke,PIS) treated in Rongjun Hospital of Hebei Province were randomly divided into combined and control groups. The patients in the control group were treated with western medicine, and the combined group was treated with Dilong and Huoxue drugs on the basis of the control group. The expression levels of hs- CRP,D-D and hemorheology in the two groups were measured before and after treatment, and the stroke scale (NIH Stroke Scale,NIHSS) and TCM symptom scores of the two groups were recorded, and compared the effective rate after treatment. Results　In the observation group, the levels of hs-CRP, D-D, high shear whole blood viscosity, low shear whole blood viscosity, plasma viscosity and hematocrit, respectively were 6.48 ±0.71 mg/L ,1.75±0.46μg/L, 4.74±1.32 MPa · s, 21.51±0.96 MPa · s,1.52±0.74 MPa · s and 31.53% ± 1.33 % , significantly better than the control group (8.57 ± 1.21 mg / L, 2.33 ± 1.02μg / L, 5.66 ± 1.43 MPa · s, 22.86 ± 0.99 MPa · s, 1.68 ± 1.22 MPa · s and 33.71%± 1.92% ),and the difference was statistically significant (t=2.851, 2.978, 2.874, 2.374, 2.482 and 2.451, all P< 0.05).According to the National Institutes of Health Stroke Scale (NIHSS) and TCM syndrome score, the effective rate (8.99±0.3 and 7.01±0.16) in the observation group was significantly better than that in the control group (10.33±0.54 and 13.36 ± 0.86), the difference was statistically significant (t=2.854 3.012, P<0.05). The total effective rate of the observation group (90%) was higher than that of the control group (70%), and the difference was statistically significant (χ2 = 2.522, P< 0.05). Conclusion　Dilong combined with western medicine can play a good clinical effect in the treatment of ischemic progressive stroke.