Objective To investigate the ef ect and safety of Defibrase combined with Aspirin in the treatment of acute ischemic stroke.Methods 88 patients with acute ischemic stroke were enrol ed in the study and al the patients were divided into three groups:Aspirin group,n=20),Defibrase group (B group,n=32)and Aspirin combined with Defibrase group (A+B group,n=36).Platelet count,platelet aggregation test (PAgT),fibrinogen ,High shear stress、Hematocrit coagulation studies (PT, APTT, INR),TXB2, National Institutes of Health Stroke Scale (NIHSS)and Modified Barthel Index (MBI)were measured or assessed before and after treatment ,respectively.Hemorrhage rate (including brain and other organs)as one of complication was also investigated.Results After treatments,A combined with B group showed the strongest inhibition of platelet aggregation among the three groups ( <0.05).TXB2 level in A group and A combined with B group was significantly lower than that in B group ( <0.05).Plasma fibrinogen level and high sheer rate were decreased significantly in B group and A combined with B group compared with A group ( <0.05, <0.01).Functional recovery in A combined with B group(70.45%)was superior to A group(17.39%)and B group(45.71%),There was no significant dif erence in systemic hemorrhage among the three groups( >0.05), The date in fol owing up 3 months showed that the scores of NIHSS and MBI in A combined with B group were bet er than those in the other two groups( <0.001). Conclusion Aspirin combined with Defibrase showed bet er clinic ef ect and less hemorrhagic risk than Aspirin or Defibrase in the therapy of acute ischemic stroke.%目的：探讨降纤酶与阿司匹林联合治疗急性缺血性脑卒中的疗效和安全性。方法将88例急性缺血性脑卒中患者分成阿司匹林治疗组(A组20例),降纤酶治疗组(B组32例)及两者联合治疗组(A+B组36例),观察治疗前后血小板计数、血小板聚集率、纤维蛋白原、高切应力、红细胞压积、凝血功能(PT,APTT,INR)、血栓烷B2(TXB2)、卒中量表评分(NIHSS)及生活自理能力(MBI)的变化,并比较出血(颅内及其它脏器出血的)发生率。结果三组治疗后血小板聚集率(60s、180s及最大聚集率)差异均有显著性(均P<0.05),A+B组作用最明显(P<0.05)；A组及A+B组TXB2水平明显降低(均P<0.05)；B组及A+B组血纤维蛋白原水平、血高切应力均降低(P<0.005,P<0.01)。生活自理能力恢复联合治疗组(70.45%)优于B组(45.71%)和A组(17.39%。出血发生率三组之间比较差异无显著性(P>0.05)。3个月时三组NIHSS、MBI比较显示联合治疗组神经功能恢复明显优于其他两组(均P<0.001)。结论降纤酶联合阿司匹林治疗急性缺血性脑卒中的疗效优于单药治疗,且安全性好。
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