| Objective: Cerebrovascular disease is characterized by the high morbidity, prevalence,mortality, disability, recurrence rate, which has been the greatest risk factor of death inChina. Watershed Infarction (WSI) is a special type of ischemic cerebrovasculardiseases and reaches an undesired result when medically treated by the correction ofhypotension, the supplement of blood volume, the improvement of hypercoagulability,the suitable enlargement of the blood capacity. In this study, Urinary Kallidinogenase(UK) is used to improve the collateral circulation and with the aid of PWI, DWI, MRA,then to observe the changes of cerebrovascular capacity (MTT, CBP, CBV, TTP) andneurological function to evaluate the therapeutical effect of UK in patients with WSI bythe improvement of collateral circulation. The research has great importance and apromising application prospect in reducing the disability and mortality caused by thecerebrovascular diseaseMethod：The60cases with WSI, in accord with diagnostic criteria for cerebralinfarction established by the Chinese Medical Association in the4th CerebrovascularDisease Conference, were collected from the Third Neurological Department of the firstaffiliated hospital of Dalian Medical University from Jan.2012to Jan.2014. All thepatients within72hours after onset received an MRI and CT examination to confirm thediagnosis of WSI and exclude the possibility of atrial fibrillation and cardiac embolusvia ECG and Heart Doppler ultrasound. These objects were divided into two groups atrandom: UK-treated group (male13, female17, age63.93±12.56), GBE-treated group(Ginkgo Biloba Extract)(male16, female14, age65.53±11.68). Before medication,brain MRI (T1weighed, T2weighed, FlAIR, DWI, PWI, MRA) was conducted, as wellas the NIHSS evaluation. Each group was treated conventionally, for example, anti-platelet aggregation and the blood lipid lowering. On this basis, all the cases wereoffered an intravenous infusion once a day, for14days,(UK-treated group: UK0.15PNA Unit+0.9%N100ml,GBE-treated group: GBE20ml+0.9%NS100ml). Then thePWI examination and NIHSS evaluation were performed respectively. The age, gender,MTT (before and after-treatment), CBF, CBV, TTP of every patient was collected.Before and after the application of PWI, the specific figures (MTT, CBF, CBV) andROI (Region of Interest) in images above were measured, then to compare bilateralfigures. These figures will be abnormal if showing a difference of20%. All the caseswere followed up for3months with NIHSS and MRS evaluation. T-test was used tomake a statistical analysis of the collected images and clinical materials in patients withcerebral infarction.Result:1．Changes of perfusion parameters before and after UK-treatment: Before drugintervention, the perfusion parameters in UK-treated group and GBE-treated groupshows no significant difference (P>0.05). However, after a14-day UK treatment, rCBV,rCBF increased and rMTT, rTTP reduced markedly in contrast to the control group(P<0.01).2．Alterations of neurological function before and after UK-treatment: neurologicalfunction in UK-treated group displays no dramatic difference when compared withGBE-treated group (P>0.05). The treatment with UK for14days demonstratedsignificantly lowered NIHSS scores (P<0.01), as well as a remarkable reduction inNIHSS and MRS scores after a3-month UK-therapy in comparison with theGBE-treated group (P<0.01).3．No obvious side effects in UK-treated group were observed before and afterUK-treatment when compared with GBE-treated group.Conclusions1．UK can improve cerebrovascular capacity in patients with WSI.2．UK can enhance neurological function in patients with WSI.3．UK has been proven safe and effective in the treatment of WSI. |
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