| Objective:This study was to estimate the clinical effect of urinary kallidinogenase on the treatment of different TOAST types of acute cerebral infarction and the changes in the concentration of plasma lysophosphatidic acid after the treatment.Methods:From October 2016 to December 2017,acute cerebral infarction patients was collected at the second affiliated hospital of Nan Chang university inpatient department according to the fourth national cerebrovascular disease conference 1995 revision of the diagnostic criteria.To screen the patients eligible for the group,all patients were subject to craniocerebral CT or MRI to diagnosis as acute cerebral infarction and eliminate the patients who has been a cerebral infarction in the past or not cerebral infarction but was taking long-term aspirin,a cerebral hemorrhage,a malignant tumor,a previously or recently with major surgery,a serious disease in important organs such as heart,liver and kidney.All patients with acute cerebral infarction which conformed the conditions after relevant auxiliary examination were classified as artery five types,atherosclerosis model(LAA),small artery occlusion model(soa),cardiac embolism(CE)and unknown causes(SUE)and other reasons(SOE),according to cerebral infarction etiology classification(i.e.,TOAST classification).Each type of acute cerebral infarction was randomly divided into control group(routine treatment group)and experimental group(based on conventional therapy plus urinary kallidinogenase),which also were treated with oxygen-absorbed,Antiplatelet aggregation of aspirin,cranial nerve nutrition,improved circulation,rehydration treatment such as capacity,and give appropriate drugs to maintain a stable blood pressure and blood sugar according to the patient's blood pressure and blood sugar.All patients used in this study were processed with National Institute of Health Stroke Scale(NIHSS)scores and the venous blood test for the measurement of plasma hemolytic phosphatidic acid content before they were given medication on the admission day.After 14 days of treatment,both the experimental group and the control group were also processed with NIHSS scores and the venous blood test again to evaluate the changes.Results:(1)Among those patients with cerebral infarction,the proportion of small atherosclerotic cerebral infarction(SAO)was the highest,33.58%;Atherosclerotic cerebral infarction(LAA)was second,accounting for 30.65%.In addition,there were 20.45% and 15.32% of the unexplained cerebral infarction(SUE)and the cardiogenic cerebral infarction(CE)respectively,while the other causes of cerebral infarction were 0.00%.(2)After acute cerebral infarction without TOAST classification,the NIHSS score of the urinary kallidinogenase group after 14 d was reduced to(5.88 + 3.75),The difference was significantly lower than that of the conventional treatment group(8.23 + 5.34)and the NIHSS(12.57 + 5.91)before treatment.The difference was statistically significant(P < 0.05).(3)Acute cerebral infarction without line TOAST classification,the lysophospholipids acid concentration of treatment group and control group after 14 d treatment were significantly decreased.Blood lysophospholipids acid concentration of treatment group is 2.17±0.74 ?mol/L,which is statistically significant(P < 0.05)lower than that of the control group(2.78±1.06 ?mol/L).(4)The concentration of plasma lysophosphatidic acid was significantly increased in the acute phase of all TOAST subtypes.Among them,the plasma lysophosphatidic acid concent of LAA and CE were 4.53±0.08 ?mol/L and 4.39±0.11 ?mol/L respectively,which are higher than other group.According to the NIHSS score of the TOAST subtype admission,the higher the content of plasma hemolytic phosphatidic acid indicated the more severe of the acute cerebral infarction.(5)In the case of the TOAST classification,the concentration of plasma hemolytic phosphatide decreased in all subtypes after treatment.LAA,CE and SUE treatment group had lower plasma LPA content than the control group,which was statistically significant(P < 0.05).Conclusion:(1)Acute phase of cerebral infarction,blood plasma lysophospholipids acid concentration of those patients were significantly increased.Among them,the LAA and CE group were higher than others.The NIHSS score of those patients associated with the patient's condition suggested that the higher the plasma lysophospholipids acid content indicated the more advanced disease.(2)Urinary kallidinogenase can obviously improve the symptoms of nerve function defect in acute cerebral infarction,and for the patients with large atherosclerotic,cardiogenic and unexplained acute cerebral infarction,it is more recommended to use Urinary kallidinogenase on the basis of conventional treatment.(3)Urinary kallidinogenase can improve the symptoms of neurological deficits in patients with acute cerebral infarction by reducing plasma LPA levels. |
PDF Full Text Request