人尿激肽原酶治疗急性脑梗死的疗效及对患者脑代谢产物的影响

[目的]应用磁共振波谱(MRS)定量分析评价人尿激肽原酶(HUK)治疗急性缺血性脑梗死(AIS)的疗效及对患者脑代谢物变化的影响.[方法]发病在72h内经核磁共振成像(MRI)确诊为AIS的患者38例,随机分为两组,对照组给予对症支持治疗,观察组在对照组的基础上给予HUK治疗.治疗前后应用MRS测定患者脑梗死周围区N-乙酰基天门冬氨酸(NAA)、肌酸(Cr)浓度,并应用美国国立卫生研究院卒中量表(NIHSS)、改良Rankin量表(mRS)评分,Barthel指数(BI)评价临床疗效.[结果]治疗前,两组梗死周围区NAA、NAA/Cr、两组NIHSS评分,mRS评分,BI指数相比较差异无显著性(P>0.05);治疗1周后,两组梗死周围区NAA、NAA/Cr均高于治疗前(P<0.05),且观察组梗死周围区治疗后NAA、NAA/Cr增加幅度高于对照组(P<0.05).两组治疗后较治疗前NIHSS评分和mRS评分降低、而BI指数升高(P<0.05),且观察组改善程度优于对照组(P<0.05).[结论]HUK治疗AIS可以改善患者梗死周围区脑细胞的代谢及临床功能,产生保护神经细胞的作用.

Effect of Human Urinary Kallikrein in Treatment of Acute Cerebral Infarction and its Effects on Brain Metabolites

[Objective]To evaluate the effect of human kallidinogenase(HUK)on the changes of brain metabo-lites in patients with acute ischemic cerebral infarction(AIS)by magnetic resonance spectroscopy.[Methods]Fif-ty-seven patients diagnosed as AIS by MRI in 72 h were randomly divided into two groups.The control group was given routine basic therapy and symptomatic supportive care.The observation group was treated with HUK on the basis of the control group.The levels of N-acetyl aspartate(NAA)and creatine(Cr)in the brain were measured by magnetic resonance spectroscopy(MRS)before and after treatment.The NIHSS was performed by the Nation-al Institutes of Health,Improved Rankin scale(mRs)score,Barthel index(BI)to evaluate clinical efficacy.[Re-sults]The values of NAA,NAA /Cr in peripheral infarcted area,NIHSS score and mRS were not significantly different between the two groups(P > 0.05)before the treatment.One week after treatment,the NAA and NAA/Cr in peripheral infarcted area of the two groups were higher than those before treatment(P <0.05).In the observation group,the increase of NAA and NAA/Cr in peripheral infarcted area was higher than that in the con-trol group(P <0.05).In regard to the NIHSS scores of the two groups after treatment,the mRS score decreased and the BI index increased compared with those before treatment(P <0.05),and the improvement degree of the observation group was better than that of the control group(P <0.05).[Conclusion]HUK treatment can improve the metabolism and clinical function of the brain cells around the infarcted area in AIS patients,and protect the nerve cells.