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| Effect of hyperhomocysteinemia on urokinase intravenous thrombolytic therapy in patients with acute cerebral infarction |
| LI Weizhou |
| Department of Neurology, Yunfu People's Hospital, Guangdong Province, Yunfu 527300, China |
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Abstract Objective To investigate the relationship between hyperhomocysteinemia (HHcy) and intravenous thrombolytic therapy of urokinase in patients with acute cerebral infarction. Methods From Apirl 2012 to May 2015, in Yunfu City People's Hospital, 91 patients with acute cerebral infarction were selected, the plasma homocysteine (Hcy) concentration was measured and they were divided into HHcy group (48 cases) and non-HHcy group (43 cases). All patients were treated with intravenous thrombolytic therapy of urokinase, the treatment time was 2 weeks, the neurological deficits, clinical treatment effect, daily living ability, vascular recanalization and incidence of adverse reactions were observed. Results The NIHSS scores of the two groups before treatment were not statistically significant (P > 0.05). The NIHSS scores of the two groups at 12 h, 48 h and 7 d were significantly lower than those before treatment (P < 0.05), these of non-HHcy group were lower than those of HHcy group at the same time (P < 0.05),these of the two groups at 48 h were lower than those at 12 h (P < 0.05), these of the two groups at 7 d were lower than those at 48 h (P < 0.05). The effective rate of non-HHcy group was significantly lower than that of HHcy group (P < 0.05), and the total effective rate of non-HHcy group was significantly lower than that of HHcy group (P < 0.05). The life self-care rate of non-HHcy group was significantly higher than that of HHcy group (P < 0.05). The recanalization rate of non-HHcy group was significantly higher than that of HHcy group (P < 0.05). The incidence of adverse reactions in HHcy group was significantly higher than that in non-HHcy group (P < 0.05). Conclusion The using of urokinase intravenous thrombolysis in the treatment of acute cerebral infarction, non-HHcy patients can significantly improve neurological deficits, improve daily living ability and clinical treatment.
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[1] 马瑞，张晓惠，徐亚辉.超选择性动脉溶栓与静脉溶栓治疗急性脑梗死临床疗效分析[J].中国老年学杂志，2012， 32（5）：919-920.
[2] 黄勇华，张微微，张国鲁，等.低剂量rt-PA联合尿激酶静脉溶栓治疗早期急性脑梗死的疗效及安全性评价[J].北京医学，2012，34（9）：834-837.
[3] 邓远琼，刘伯胜，邓远琪，等.急性脑梗死患者血管内皮功能和同型半胱氨酸水平变化及其治疗[J].中国全科医学，2013，16（32）：3057-3061.
[4] 张磊，刘建民.美国国立卫生研究院卒中量表[J].中华神经外科杂志，2014，30（1）：79.
[5] 全国第四届脑血管病学术会议.脑卒中患者临床神经功能缺损程度评分标准（1995）[J].中华神经科杂志，1996，29（6）：381-383.
[6] 闵瑜，吴媛媛，燕铁斌.改良Barthel指数（简体中文版） 量表评定脑卒中患者日常生活活动能力的效度和信度研究[J].中华物理医学与康复杂志，2008，30（3）： 185-188.
[7] Toda N，Okamura T. Hyperhomocysteinemia impairs regional blood flow： involvements of endothelial and neuronal nitric oxide [J]. Pflugers Arch，2016，468（9）：1517-1525.
[8] 寇雪莲，陈琳迪，何松彬，等.高同型半胱氨酸血症对急性脑梗死患者预后的影响[J].中华全科医学，2015，13（5）：697-699.
[9] Hori Y S，Kodera S，Sato Y，et al. Eosinopenia as a predictive factor of the short-term risk of mortality and infection after acute cerebral infarction [J]. J Stroke Cerebrovasc Dis，2016，25（6）：1307-1312.
[10] 党哲，张国鲁，张微微，等.rt-PA联合尿激酶静脉溶栓治疗急性脑梗死的疗效及安全性研究[J].脑与神经疾病杂志，2014，22（4）：287-291.
[11] 祁瑞芳.老年脑梗死患者高同型半胱氨酸血症、氧化应激及炎性反应的相关性[J].中国老年学杂志，2014，34（8）：2070-2071.
[12] 张玉杰，李淑娟，关明，等.高同型半胱氨酸型高血压与急性脑梗死的相关性分析[J].中国脑血管病杂志，2011， 8（12）：637-640.
[13] 李建新，杜婴，李柱一，等.高同型半胱氨酸血症对急性脑梗死短期预后的影响[J].中风与神经疾病杂志，2012， 29（7）：651-653.
[14] 王春燕.急性脑梗死患者高同型半胱氨酸血症的研究进展[J].中西医结合心脑血管病杂志，2013，11（11）：1376-1378.
[15] 王素红.高同型半胱氨酸血症对2型糖尿病交感神经功能状态的影响[D].天津：天津医科大学，2012.
[16] 胡如海，廖新宇，向玲.高同型半胱氨酸血症对急性缺血性脑卒中患者近期预后的影响[J].神经损伤与功能重建，2016，11（5）：434-435.
[17] 贵海峰.叶酸和维生素B12对伴HHcy冠心病患者PCI术后Hcy和CRP浓度影响的研究[D].石家庄：河北医科大学，2015.
[18] 刘红钊，张保朝.尿激酶静脉溶栓治疗对脑梗死患者血液流变学影响观察[J].中国实用医药，2013，8（1）：159-160.
[19] 姚力，沙娟娟，何剑波，等.高同型半胱氨酸血症对急性脑梗死患者小剂量重组组织型纤溶酶原激活剂静脉溶栓短期疗效影响[J].实用老年医学，2015，23（10）：861-863.
[20] 王莹，李慧英，甄伟兰，等.腔隙性脑梗死早期患者同型半胱氨酸、高敏C反应蛋白及认知功能的临床分析[J].中国医药导报，2015，12（31）：93-96.
[21] 肖亚，胡刚琴.同型半胱氨酸和血脂对急性脑梗死患者静脉溶栓治疗效果的影响探讨[J].世界临床医学，2016， 10（24）：265-268. |
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