目的 研究小牛血清去蛋白联合组织型纤溶酶原激活剂治疗脑梗死的疗效。方法 选择2014年3月-2015年3月唐山康复医疗中心收治的脑梗死患者120例,随机分成对照组和治疗组,每组各60例。对照组患者给予重组组织型纤溶酶原激活剂注射粉剂,溶于无菌注射用水中,取其中的10%进行静脉注射,剩余的90%应在50min内及时进行静脉滴注,使用剂量为0.6mg/kg(最大剂量≤50mg);治疗组在对照组的基础上静脉滴注小牛血清去蛋白注射液,30mL溶于250mL生理盐水,1次/d。两组患者均连续治疗2周。观察两组的临床疗效,比较两组治疗前后神经功能缺损(NHISS)评分、简易智能精神状态量表(MMSE)和血液流变学指标。结果 治疗后,对照组和治疗组总有效率分别为63.3%、78.3%,两组总有效率比较差异具有统计学意义(P<0.05)。治疗后,两组患者NIHSS评分较治疗前明显下降,MMSE较治疗前明显升高,同组治疗前后差异有统计学意义(P<0.05);且治疗组这些观察指标的改善程度优于对照组,两组比较差异有统计学意义(P<0.05)。两组患者的血浆比黏度和血小板聚集率均显著降低,同组治疗前后差异有统计学意义(P<0.05);且治疗组这些观察指标的降低程度优于对照组,两组比较差异有统计学意义(P<0.05)。结论 小牛血清去蛋白联合组织型纤溶酶原激活剂治疗脑梗死具有良好的疗效,能够显著降低NIHSS评分,明显升高MMSE,并能明显改善患者的血液流变学指标,具有一定的临床推广应用价值。

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.