摘要
目的动态监测巴曲酶治疗急性脑梗死患者血浆纤维蛋白原(Fib)水平变化,以探讨降纤治疗的靶水平。方法分别对急性脑梗死患者使用巴曲酶常规剂量(10BU、5BU、5BU,隔日静脉注射)组20例和大剂量(10BU、10BU、5BU、5BU,隔日静脉注射)组30例进行治疗和观察,基础治疗相同。用药前、第1次用药后8～12h,及以后每次用药前4～6h检测血凝常规,发病第2～3周复查头颅CT或MRI,3个月时进行Barthel指数评分。结果第1次用药后12hFib明显下降,第2次用药前迅速回升,并在治疗过程中保持基本稳定;Fib水平(40～69)mg/dl组活化部分凝血活酶时间(APTT)和/或凝血酶原时间(PT)较Fib水平>130mg/dl组延长(P<0.05)。结论巴曲酶治疗可使急性脑梗死患者的Fib处于(40～130)mg/dl水平,其能否作为降纤治疗的靶水平还有待进一步探讨。
Objective To explore the dynamical change of fibrinogen levels treated by Batroxobin in patients with acute cerebral infarction in order to approach a target level of defibrinogen therapy. Methods Fifty patients with acute cerebral infarction were randomly divided into routine dose group （20 cases） and high dose group （30 cases）. The patients in routine dose group and high dose group were treated intravenously with Batroxobin 10 BU, 5 BU, 5 BU and 10 BU, 10 BU,5 BU, 5 BU in every other day, respectively. The routine function of blood coagulation was examined before drug administration, at 8～12 h after first administration and at 4～6 h before afterward administrations. Brain CT or MRI scan was performed at 2 ～3 weeks after the onset of disease, and the grading of Barthel index was evaluated at 3 months after the treatment. Results The blood level of fibrinogen dropped obviously at 12 h after the first administration of Batroxobin, went up rapidly before the 2nd administration, and then kept stability in the course of treatment. The prolong of APTT and/or PT in low fibrinogen level group （40 -69 mg/dl） was more than in high fibrinogen level group （ 〉 130 mg/dl）. Conclusions The fibrinogen level may reduce to 40 - 130 mg/dl treated with Batroxobin in patients with acute cerebral infarct, but whether it could be regarded as a target level need more studies.
出处
《临床神经病学杂志》
CAS
北大核心
2006年第4期275-277,共3页
Journal of Clinical Neurology
关键词
巴曲酶
脑梗死
降纤治疗
靶水平
Batroxobin
crebral infarction
defibrinogen therapy
target level
