Curative Effect And Safety Of Combining Drug Of Defibringen, Anticoagulation, Antiplateletget To Treat Thrombosis

Progressivity storke, it was point the phenomenon that nerve afunction have not got any top at 6 hour from attacking whereas at 48 hours or more gradualness progressing or aggravating.disease incidence is about between 12% to 42%.It was result in apoplexy evolutional substantial clause that thrombi keep on headway.How to cure stroke was key in stopping progressiving stroke. As the drug of antithrombus make function through restrain cruor course,at the same time risking bloody(brain,skin,internalorgan,et),in pharmic specification give clear indication of prohibitting or careful jointing with other drug of antithrombus .Owing to drug of antithrombus make operating priority through one link of restraining thrombolic process,impact less rest link,so make it is possible to joint application of different antithrombus drug.After one intracephalic vascular occlusion, blood stream decrease at once,the centre of the infarct necroses quickly. owing to collateral circulation presence of ischemia perimeter zone ,ischemia injure dose not reach inconvertibility phase. It is crucial importance to prevent microthrombus forming and remain valid microcirculation for preventing headway of state of illness. Theoretically,it is more significant to cure and prevent much target spot ischemia apoplexyby jointing different active mechanism resist pin medicament than singleness medicine.In our clinic course,we found that it could procure best clinical effectiveness in the course of combining different active mechanism drug of antithrombus to cure progressivity cerebral infarction on occasions of regulationdosage and monitoring in time,and the bad clinic event incidence is very low.In this research we divide randomly progressivity stroke inpatient who had been cured during november to december of 2006 into two groups : cure group and control group. As the foundation curing,Diemailing was applied to all patients of two groups. Drug applied to control group is normal saline 250ml+Ozagrel 80mg quiescent 2/d;Low Molecular Heparin 5000U 1/d hypodermic injection.At the foundation of upper treatment, DF-521 was applied to the cure group, the application is normal saline 250ml+DF-521 10U at the 1st, normal saline 250ml+DF-521 5U at the 3rd and the 5th in the course of treatment by quiescent point.Contras-ting the nervous system grade (CSS) got fore-and-aft,it was verdicted improve with nervous system grade decreasing.we get respectively improvement rate of two groups.During the course of treatment , the plasma fibrinogen level, prothro-mbin time(PT) , part enabled prothrombin time(APTT), liver function,renal function, routine of urine examination,occu- lt blood of sedes had been monitored; at the same time hemorrhage instance such as intracranial hemorrhage, internal organ hemorrhage, skin and mucous membrane hemorrhage et,had been observed ether. Contradistinction of the nervous function improvement rate between two groups was tested by X2.It was the T test in spss11.5 adopted to test fibrinogen (fib), prothrombin time(PT), part enabled pro-thrombin time(APTT) of cure fore and aft. It was found that nerve afunction grade and age before treatment of two-sets had not statistics difference, p>0.05;In all 121 patients of cure group,106 patients CSS decreased, improvement rate 87.60%;In 113 patients of control group,82 patients CSS decreased , improvement rate were 72.57%. It had significant statistic difference between improvement rate of tow groups group tested by X2, P<0.01; Curegroup in contrast to control group ,it had not statistics difference of Fib, PT, APTT tested before treatment,which was tested by spss11.5 ,P>0.05;In the cure group, contrast of Fib level treatment fore and aft had statistics significance, p<0.05;In the control group, contrast of Fib level treatment fore and aft had not statistics differenc, P>0.05;Fib level which tested after treament had statistics significance,P<0.05;In the cure group, contrast of PT and APTT treatment fore and aft had statistics significance,P<0.05,In control group,we can get same result that is P<0.05; cure group in contrast to control group, PT and APTT got after treatment had not statistics difference P>0.05.There were 4 patients who was found ecchymosis in the cure group,and they were 3 patients who was found ecchymosis in the control group.The ecchymosis which area is 0.5-2.0cm2,lies in injection site of belly and hand.Cure group contrast to control group,there had not statistics difference of the ecchymosis incidence,tested by X2,P>0.05.There did not found intracranial hemorrhage, hematemesis, 0melena, hematuria during hospitalization.There were not significant anomaly in liver function, kidney function,and thrombocyte quantity.In the research which contain patients whose curing time is after 72 hours from the beginning, nerve function improvement rate between cure group and control group, had not statistics difference. This phenomenon shows that combined treatment of defibringen , anticoagulation, antiplatelet has conspicuous effect, in early stages(within 72 hours).During the clinical treatment, we put forward the condition of combining the drug of defibringen, anticoagulation, antiplatelet :The patient or his surrogate refuse to be treated with thombolysis therapy within 6 hours after the attack; The man whose stroke aggravates and the time of therapy is longerthan 6 hours while less than 72 hours ;It aggravates repeatedly after other means of therapy was applied during the treatment. It need to exclude following event: 1,The patient who was attacked not only by cerebral infarction but also attacked at the same time by desease of intracranial hemorrhage ,or has hemorrhagic incline with other systems ,such as nosohemia, ulcer , reactiveness pulmonary tuberculosis, menstrual period,et.2, The patient whose blood pressure still higher than 180/100mmHg,though the blood pressure had been treated by drug. 3,The patient who has severity deseases of liver and kidney. 4,The patient in which there may be mural thrombus. 5,The patient in which there may be encephalic vascular malformation or aneurysm. 6,The patient who had been diagnosised as large area cerebral infarction. 7,The patient whose plasma fibrinogen level is less than 1.0g/L before the beginning of the treatment.8,The patient or his surrogate refuse to be treated by drug combination. In the course of treatment ,there are some event that need stopping drug combination: 1,There are severity hemorrhagic tendency in the coures of treatment;2,It is definite that some drug ingredient induce to anaphylactic disease;3, liver function or kidney function is damaged badly;4, other severe clinical event caused definitely by drug combi-nation. There are some incident need to pause drug combination during the course of treatment ,that is plasma fibrinogen level less than 1.0g/L or APTT extend 1 times or more. Before we make the therapy of drug combination ,we should let the patient or his surrogate make clear that during the cause of treatment with drug combination,adverse reaction may emerge ;and should affix agreement of knowing the inside story. During remedial course, Fib, PT, APTT should be monitored ,as well as the emerging disadvantage clinic event ,such as :hemorrhage, hypersensitive-ity, et. In some patients ,we find the phenomena that plasma fibrinogen is in a high level all the time ,and the other phenomena that the plasma fibrinogen bounced in a high level again after cease treatment.It was found that this part patient had a badly prognoses through clinical observati- on.In the cause of curing thrombosis, combining defibringen, anticoagu- lation ,antiplateletget to treat patient in different target has remedial rationale, can get preferable curative effect and has reliability. therapy that combine drug of defibringen, anticoagulation, antiplateletget to treat thrombosis is a sort of good means.