Study On The Effect Of Urinary Kallidinogenase In Treatment Of Acute Cerebral Infarction

Background:Ischemic stroke implies brain tissues necrosis or softening due to blood circulation disorders caused by ischemia or hypoxia. According to the epidemiology statistics, the average annual incidence of stroke in China showed a trend of increasing growth, the incidence was approximately 120/100000, which ischemic stroke accounted for about more than 70%, occupied the main position. Clinical experiment statistics prove that there are significant differences in the therapeutic effect of ischemic stroke patient. many factors such as age, basic conditions of blood vessels, can affect the prognosis of patients indeed, but there are a lot of studies showing that the establishment of collateral circulation after cerebral ischemia, also is one of key factors.Cerebral collateral circulation is that when stenosis or occlusion occur in cerebrovascular, anastomosis tube will be formed to ensure the basic blood supply of area of stenosis or occlusion, which to avoid ischemic necrosis and maintain the body’s normal physiological function. There are basically the following three:the first collateral circulation refers to Willis ring formation of the brain. The secondary collateral circulation refers to the compensatory of blood flow through ophthalmic artery and pia vessels. The third collateral circulation is the new blood vessels. If collateral circulation establish immediately after cerebral ischemia, the defect degree of nerve function will also reduce to a minimum. It is confirmed that effective collateral circulation can stable cerebral blood flow of infarction area, reduce the infarction volume, improve ischemia after brain tissue injury, alleviate blood reperfusion damage, reduce bleeding after infarction, improve prognosis and reduce the risk of recurrence, etc. Urinary kallidinogenase is the main clinical drug in the treatment of ischemic stroke to promote the recovery of nerve function, and improve prognosis. This study is mainly to prove the effectiveness of urinary kallidinogenase to establish collateral circulation establishment basis and find ways to evaluate the collateral circulation, so as to provide guidance for clinical treatment of ischemic stroke.Purpose:To explore the effect of urinary kallidinogenase in treatment of acute cerebral infarction.Methods:The study population came from Zhongda hospital affiliated Southeast university, in Nanjing Jiangsu province. They were ischemic stroke patients proved by CT or MRI in department of Neurology after june.2015 with an age between 40 and 80 years old and the attack time within 7 days. A total of 40 patients were collected and divided into the treatment group (n= 20) and the control group (n= 20), the control group was given conventional treatment of cerebral infarction, the treatment group was given urinary kallidinogenase 0.15 PNA U/d through an intravenous drip on the basis of conventional treatment.Patients combined with hypertension, diabetes, coronary heart disease, carotid plaques, hyperlipidaemia were all given symptomatic treatment. The National Institutes of Health Stroke Scale Score (NIHSS score) was used to assess the neurological functions of patients, before treatment,14 days after treatment and 90 days after treatment. The Barthel index (BI) was used to assess the daily living ability of patients before treatment, fourteen days after treatment and 90 days after treatment. At the same time, patients received multi-mode MRIs and were recorded basic vital signs, adverse reactions. At last, we did data analysis and came to a conclusionResults:There was no evident difference in age, gender, and history of high blood pressure, coronary heart disease and diabetes scores, carotid plaques, hyperlipidaemia, HCY and smoking in both groups.Comparison of NIHSS of experimental group and control group before and after treatment, The NIHSS score was reduced.there was difference before and after treatment(average p less than 0.05). The BI of both groups were increased, there was difference before and after treatment(average p less than 0.05). There was no evident difference in NIHSS and BI in both groups before treatment (average p less than 0.05). There was also no evident difference in NIHSS and BI in both groups after treating two weeks (average p less than 0.05). The NIHSS score has obviously improved (average p less than 0.05) 90 days after treatment respectively. The experimental group is better than the control group (p less than 0.05).The BI score has improved (average p less than 0.05) 90 days after treatment. The experimental group is better than the control group (p less than 0.05). The total effective rate of treatment group was higher than the control group (p< 0.05).Conclusion:Urinary kallidinogenase can improve the curative effect and neurological functions of the patients of acute cerebral infarction.