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1、%临床荟萃&2010年8月5日第25卷第15期ClinicalFocus,August5,2010,Vol25,No.151311论著早期应用水蛭素治疗脑出血的临床研究刘在贵1,程方敏2(1.滨州医学院生物化学与分子生物学教研室,山东滨州256603;2.滨州市人民医院神经内科,山东滨州256610)摘要:目的观察水蛭素注射液对自发性脑出血血肿吸收、血肿周围低密度区改变及对神经功能恢复的影响。方法将425例入选的自发性脑出血患者随机分为治疗组308例和对照组117例。治疗组给予水蛭素注射液6ml加入5%葡萄糖液250ml中静脉滴注,每日1次。分别于治疗前和治疗后
2、4、10、21天利用CT测量血肿体积及血肿周围低密度区,采用欧洲卒中量表进行神经功能缺损评分。结果治疗组第10、21天血肿体积均明显低于对照组,(2110)mlvs(278)ml,(147)mlvs(259)ml(P<0.01);治疗组21天时血肿周围低密度区小于对照组,(1.50.4)mmvs(3.00.7)mm(P<0.01);治疗组第10、21天欧洲卒中量表神经功能缺损评分(ESS)均明显高于对照组,(6219)分vs(4616)分、(6624)分vs(5114)分(P<0.01)。结论早期应用水蛭素注射液能促进脑出血血肿的吸收,使血肿周围低密度区缩小和
3、促进神经功能恢复。关键词:脑出血;水蛭素类;病例对照研究中图分类号:R743.34文献标识码:A文章编号:1004583X(2010)15131103ClinicalresearchofearlyapplicationofhirudintherapyoncerebralhemorrhageLIUZaigui1,CHENGFangmin21.DepartmentofBiochemistry,BinzhouMedicalCollege,Binzhou256603,China;2.DepartmentofNeurology,BinzhouMunicipalPeople!sHo
4、spitalinShandongProvince,Binzhou256610,ChinaABSTRACT:ObjectiveToinvestigatetheeffectsofhirudinonabsorptionofintracerebralhematoma,changesoflowdensityareasurroundinghematoma,andrecoveryofneurologicalfunctioninpatientswithspontaneousintracerebralhemorrhage.Methods425patientswithspontaneousi
5、ntracerebralhemorrhagewererandomlydividedintotreatmentgroupandcontrolgroup,308casesand117casesrespectively.Thepatientsintreatmentgroupwereintravenouslygiventhemixtureofhirudinsolution6mland5%glucose250mloncedaily.ThevolumeofhematomaandlowdensityareaaroundhematomaweremeasuredbyCTbeforeandaf
6、tertreatmentat4,10and21days,theneurologicalfunctionwasscoredbytheEuropeanStrokeScale.ResultsHematomavolumeinthetreatmentgroupwassignificantlysmallerthanthatinthecontrolgroupatthe10thand21thdayrespectively,(2110)mlvs(278)ml,(147)mlvs(259)ml(P<0.01).Thelowdensityareaaroundhematomainthetre
7、atmentgroupwassignificantlysmallerthanthatinthecontrolgroup,(1.50.4)mmvs(3.00.7)mm(P<0.01).Theneurologicalfunctionscoreinthetreatmentgroupwassignificantlyhigherthanthatinthecontrolgroupat10thand21stdayrespectively,(6219)fractionsvs(4616)fractions,(6624)fract
