| ObjectiveTo observe the effects of human urinary kallidinogenase(HUK) on intracranial collateral circulation in patients with acute cerebral infarction and to explore its probably mechanisms.MethodThis is a prospective,nonrandomized,open trial in single center.The main inclusion criteria was acute cerebral infarction within 72 h and the NIHSS＜10.The patients were divided into HUK group received HUK for 7 days and control group. The primary endpoints were improvement of collateral circulation[＞10cm/s augment of mean blood flow velocity(Vm) assessed by transcranial Doppler sonography] immediately and 7 days after the treatment.The secondary endpoints included an improvement of blood flow of the criminal artery at the same time points,and the clinical neurological efficacy(NIHSS reduced at least 18%).Blood was collected for the measurement of nitrogen oxide(NO) and prostacyclin(PGI2) before and 7 days after the treatment.ResultsA total of 64 cases were enrolled into this trial from October 2007 to June 2008, with each group 32 cases.The basic characteristics showed no significant difference. After the first dosage of HUK,34.4%of the patients demonstrated an immediately improvement of blood flow at the collateral artery or arteries,and 21.9%in the criminal artery,and none showed a decreased blood flow.One week after the treatment,this improvement of collateral circulation weakened gradually and unchanged at the criminal artery as compared to control group.The efficacy rate at 7 days in HUK group was significant higher than that in control subjects(78.1%,VS 50.0%,p 0.04).There was no difference for blood NO or PGI2 concentration in HUK group and control group.ConclusionThe use of HUK can immediately improve the early intracranial collateral circulation after acute cerebral infarction,with no blood-steal phenomenon.This may be the possible mechanism of HUK to treat acute cerebral infarction.With time elapsed to 7 days,this improvement of blood flow weakens gradually.HUK may have no obvious effect on NO and PGI2 metabolisms 7 days after the treatment. |
