急性脑梗塞患者血管内皮细胞活性因子的变化和活血化瘀对其影响的临床观察

为探讨急性脑梗塞中医不同证型与血管内皮细胞的关系，以及活血化阏对其影响。方法对２０名健康得及６６例ＡＣＩ偏虚证和偏实证患者检测了血浆纤缩溶解系统，前列环素系统以及第Ⅷ因子相关抗原等的水平。

Clinical Study on Active Factors of Vascular Endothelial Cells in Acute Cerebral Infarction Patients and Therapeutical Effect of Activating Blood Stasis

OBJECTIVE: To investigate the level of plasma tissue plasminogen activator (tPA), plasminogen activator inhibitor (PAI), 6-keto-prostaglandin F1 alpha(PGF1 alpha), thromboxane B2(TXB2), factor VIII related antigen (VIII R:Ag) in acute cerebral infarction (ACI) patients with different TCM syndrome-type and the therapeutical effect of activating blood stasis (ABS). METHODS: Plasma fibrolysin system, prostaglandin system, and VIII R:Ag of 20 healthy subjects and 66 ACI patients were determined. The 45 of 66 cases were treated with ABS randomly and prospectively, 20 cases were treated by difibrase batroboxobin (DF-521), only 25 cases were treated by DF-521 together with Heart-Brain Mixture (HBM), on activating blood stasis mixture, concurrently. RESULTS: (1) The activity of tPA, ratio of tPA/(tPA + PAI) and level of PGF1 alpha decreased significantly, the level of VIII R:Ag increased remarkably in ACI patients than those of the controlled subjects. (2) Between Differentiation of Deficiency and Excess Syndromes, the level of above index changed more remarkably in the case with Excess Syndrome. Insignificant change of index shown in Deficiency cases except activity of tPA. (3) No more improvement of nerve impairment was shown between group of DF-521 together with HBM and DF-521 alone within 30 days. However, the improvement of index such as level of VIII R:Ag, ratio of tPA/(tPA + PAI) and TXB2/PGF1 alpha showed significant change between the beginning and end of treatment of DF-521 with HBM group. CONCLUSIONS: The vascular endothelial impairment was more serious in ACI patients with Excess than those with Deficiency Syndrome. DF-521 combining with HBM could protect vascular endothelial cells and improve the fibrolytic system and prostaglandin system.