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Objective To explore the clinical benefits and risks of intravenous thrombolysis combined with urinary kallidinogenase in the treatment of minor stroke.Methods The clinical data of 86 patients with minor stroke were retrospectively analyzed.Patients who received intravenous thrombolysis combined with urinary kallidinogenase were included in observation group (n =48),and those who received intravenous thrombolysis alone were included in control group (n =38).Before treatment and after 2 weeks of treatment,the imaging blood flow perfusion parameters [cerebral blood flow (CBF),mean transit time (MTT),time to peak (TTP)],and breath holding test indexes [cerebral vascular reactivity (CVR),breath holding index (BHI)] and serum biochemical indicators [vascular endothelial growth factor (VEGF),basic fibroblast growth factor (bFGF)] were compared between the two groups.The occurrence of adverse drug reactions during course of treatment and rehabilitation effects at 3 months after treatment [US National Institutes of Health Stroke Scale (NIHSS),modified Rankin Scale (mRS)] were analyzed in the two groups.Results After 2 weeks of treatment,the CBF,CVR,BHI and serum levels of VEGF and bFGF in the two groups were significantly higher than those before treatment,and the indexes in observation group were significantly higher than those in control group (P ＜ 0.05).The MTT and TTP levels in the two groups were significantly higher than those before treatment,and the levels in observation group were significantly higher than those in control group (P ＜ 0.05).There was no significant difference in the incidence rate of adverse drug reactions between the two groups during course of treatment (P ＞ 0.05).At 3 months after treatment,there was no statistically significant difference in the effective rate of rehabilitation between the two groups (P ＞ 0.05),but the Mann-Whitney U rank sum test between-groups showed that the overall rehabilitation effects in observation group were significantly better than those in control group (P ＜ 0.05).Conclusions Intravenous thrombolysis has certain treatment effects in patients with minor stroke,and its safety is within the clinical controllable range.Combined with urinary kallidinogenase can obtain ideal longterm prognosis,and it is beneficial to the recovery of neurological function.
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Objective@#To explore the clinical benefits and risks of intravenous thrombolysis combined with urinary kallidinogenase in the treatment of minor stroke.@*Methods@#The clinical data of 86 patients with minor stroke were retrospectively analyzed. Patients who received intravenous thrombolysis combined with urinary kallidinogenase were included in observation group (n=48), and those who received intravenous thrombolysis alone were included in control group (n=38). Before treatment and after 2 weeks of treatment, the imaging blood flow perfusion parameters [cerebral blood flow (CBF), mean transit time (MTT), time to peak (TTP)], and breath holding test indexes [cerebral vascular reactivity (CVR), breath holding index (BHI)] and serum biochemical indicators [vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF)] were compared between the two groups. The occurrence of adverse drug reactions during course of treatment and rehabilitation effects at 3 months after treatment [US National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS)] were analyzed in the two groups.@*Results@#After 2 weeks of treatment, the CBF, CVR, BHI and serum levels of VEGF and bFGF in the two groups were significantly higher than those before treatment, and the indexes in observation group were significantly higher than those in control group (P<0.05). The MTT and TTP levels in the two groups were significantly higher than those before treatment, and the levels in observation group were significantly higher than those in control group (P<0.05). There was no significant difference in the incidence rate of adverse drug reactions between the two groups during course of treatment (P>0.05). At 3 months after treatment, there was no statistically significant difference in the effective rate of rehabilitation between the two groups (P>0.05), but the Mann-Whitney U rank sum test between-groups showed that the overall rehabilitation effects in observation group were significantly better than those in control group (P<0.05).@*Conclusions@#Intravenous thrombolysis has certain treatment effects in patients with minor stroke, and its safety is within the clinical controllable range. Combined with urinary kallidinogenase can obtain ideal long-term prognosis, and it is beneficial to the recovery of neurological function.
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Objective: To observe the effects of different doses of human urinary Kallidinogenase (HUK) on the expression of bradykinin 1 receptor (B1R) and bradykinin 2 receptor (B2R) in SD rats with middle cerebral artery occlusion(MCAO). Methods: The right MCAO model of SD rats was established by modified Zea Longa thread thrombus method. The 25 successfully prepared SD rats were randomly divided into five groups (5 in each group):the Sham group,the I/R model group (I/R +saline group),the HUK low dose treatment group (I/R + LDP group),the HUK medium dose treatment group (I/R + MDP group) and the HUK high dose treatment group (I/R + HDP group). After 30 min,each group was given HUK (the I/R + LDP group:3. 50 × 10-3 PNAU/kg;the I/R + MDP group:8. 75 × 10-3 PNAU/kg;the I/R + HDP group: 17.50 × 10-3 PNAU/kg) or saline tail vein injection for continuous 7 days. The samples were taken after regular injection once a day. The relative expression of mRNA in the marginal area of infarction was detected by real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR),and microvascular growth density (MVD) was measured by vWF factor inimuno -fluorescence (FITC). Results (1)B1R mRNA expression;Compared with I/R + saline group, the mRNA expression of B1R in I/R + LDP group,I/R + MDP group,I/R + HDP group was all up-regulated ([0. 34 ± 0. 05], [0. 35 ± 0. 04], [0. 47 ± 0. 03] vs. [0.23 ±0.05],all P <0.05);Compared with I/R + LDP group and I/R + MDP group,the mRNA expression of B1R in I/R +HDP group was was all up-regulated (all P<0.05). (2)B2R mRiNA expression:Compared with Sham group, the mRNA expression of B2R in I/R + saline group was up-regulated([0.33 ±0.01]vs. [0.23 ± 0. 02],P <0. 05);Compared with I/R + saline group, the mRNA expression of B2R in I/R + LDP group, I/R +MDP group, I/R + HDP group was all up-regulated ([0. 49 ± 0. 02], [0. 52 ±0. 04], [0. 71 ± 0. 03], respectively,all P < 0. 05); Compared with I/R + LDP group and I/R + MDP group, the mRNA expression of B2R in I/R + HDP group was was all up-regulated (all P <0. 05). (3) Compared with Sham group, the microvessel density(MVD)in I/R + saline group was increased ([169 ±6]vs. [74 ± 12],P < 0.01);Compared with I/R + saline group,the MVD in I/R + LDP group,I/R + MDP group, I/R + HDP group was all increased([240 ±9], [252 ±9], [349 ± 17].respectively,all P<0.01);Compared with I/R + LDP group and I/R + MDP group, the MVD in I/R + HDP group was increased (all P < 0. 01). Conclusion: A certain dose of HUK could upregulate the expression of Bl R and B2R in MCAO rats to promote vascular regeneration,and the effect of high dose HUK on neovascularization was more obvious.
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Objective To evaluate the clinical efficacy of urinary kallidinogenase combined with sodium ozagrel on acute cerebral infarction.Methods Totally 170 cases of acute cerebral infarction were randomly and equally divided into control group and treatment group.The control group was treated with ozagrel sodium while the treatment group was given urinary kallidinogenase combined with ozagrel sodium.The clinical efficacy, HINSS score, infarct volume, blood rheology and adverse reactions of the two groups were observed.Results There was no significant difference in such general data as gender, age, site of disease and complications between the two groups (P>0.05).The efficacy of the treatment group was significantly better than that of the control group (Z=-2.28, P=0.02).The NIHSS score before and after treatment was (23.38±3.24) vs (12.22±7.17) respectively in the control group,and (23.18±2.96) vs (9.16±6.95) in the treatment group.The effect in the treatment group was better than in the control group (t=2.83,P<0.05).The infarct volume before and after treatment was (5.99±0.60) vs (5.00±0.34)respectively in control group, and(5.99+0.62) vs (4.00±0.21)in the treatment group.The effect in the treatment group was better than in the control group (t=23.11,P<0.05).Blood rheology indexes, fibrinogen, plasma viscosity, whole blood low shear viscosity and whole blood viscosity improvement in the treatment group were better than those in the control group (t=14.67,7.35,19.70和5.33,P<0.05).The two groups were not significantly different in the incidence of adverse reactions.Conclusion Yuri Klein combined with ozagrel sodium can effectively treat acute cerebral infarction by repairing the damaged neurons and improving the prognosis of patients,without obvious adverse reactions.It is worthy of clinical promotion.
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Objective To study the mechanism of urinary Kallidinogenase combined with aspirin in treat-ment of acute cerebral infarction. Methods Eighty-six patients with acute cerebral infarction were randomly divid-ed into the observation group(n=43)and the control group(n=43).The observation group was treated with uri-nary Kallidinogenase combined with aspirin,while the control group was treated only with aspirin.Two weeks after the treatment,variables of hemorheology,serum Hcy,hs-CRP,VEGF,IL-6,Cys-C,neurological deficit(NI-HSS)and daily living ability(ADL)were compared between the two groups. Results After treatment,the serum Hcy,hs-CRP,VEGF,Cys-C,IL-6 levels,the NIHSS and ADL in the observation group were significantly better improved than those of the control group(P<0.05).The clinical efficacy in the observation group was significantly higher than that of the control group[95.35%(41/43)vs 74.42%(32/43)](P<0.05).Conclusion Urinary Kal-lidinogenase combined with aspirin is more effective in the treatment of acute cerebral infarction. The mechanism may be related to the early improvements of serum Hcy,hs-CRP,VEGF,Cys-C and IL-6 expression.
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OBJECTIVE:To observe clinical efficacy of urinary kallidinogenase in the treatment of acute cerebral watershed in-farct (WSI). METHODS:128 patients with WSI were randomly divided into control group and treatment group,each of the 64 cases. Control group was given Shuxuening 15 ml added into 0.9% Sodium chloride 250 ml,ivgtt,qd;treatment group received urinary kallidinogenase 0.15 PNA added into 0.9% Sodium chloride 100 ml,ivgtt,qd. Both groups were treated for consecutive 14 days. Neurologic impairment score(NIHSS)and clinical efficacy were observed in 2 groups before treatment and 3,7 and 14 days after treatment. The blood specimens were collected after 7 and 14 days treatment,to determine serum levels of TCC. RESULTS:After treatment,NIHSS and total effective rate of treatment group were significantly higher than those of control group,with statis-tical significance(P0.05);7 days af-ter treatment,TCC level of 2 groups increased significantly,to 14 days,and a declive;the treatment group was higher than the control group,with statistical significance (P<0.05). CONCLUSIONS:Urinary kallidinogenase can improve clinical efficacy of WSI significantly,and promote neurologic impairment symptom and TCC levels.
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Objective To assess the efficacy and safety of urinary kallidinogenase combined with sodium ozagrel for cerebral infarction (CI), and provide references for clinical rational drug use. Methods Retrieved from Cochrane library, PubMed, CBM, FMJS, VIP, Wangfang database and CNKI ( published until January 2015), randomized controlled trails (RCT)about urinary kallidinogenase combined with sodium ozagrel for treatment of CI were included,then methodological quality were evaluated and statistical analysis of those studies were carried out by Rev Man 5.3.4 software. Results 19 RCTs were included,involving 1 747 patients. Results of Meta-analysis showed that urinary kallidinogenase combined with sodium ozagrel could significantly improve total effective rate[RR= 1.18, 95%CI(1.13, 1.23), Z= 7.97, P<0.000 01], cure rate[RR = 1.42, 95%CI(1.23, 1.64), Z= 4.86, P<0.000 1], neurological deficit scores[MD= -4.40, 95%CI(-5.36, -3.43), Z= 8.90,P<0. 000 01] and activity of daily living scores[MD = 19.14, 95%CI(17.39, 20.90), Z = 21.36, P<0.000 01]. Conclusion Urinary kallidinogenase combined with sodium ozagrel was effective in the treatment of CI, and no significant adverse reactions were observed. The combination therapy was worthy of clinical application.
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OBJECTIVE:To observe the clinical efficacy and safety of triple therapy of aspirin,clopidogrel and urinary kallidi-nogenase in the treatment of recurrent transient ischemic attack. METHODS:180 patients with recurrent transient ischemic attack were randomly divided into control group and observation group. Control group was orally treated with Aspirin enteric-coated tab-lets 100 mg,once a day + Clopidogrel hydrogen sulfate tablets 75 mg,once a day. Based on the treatment of control group,obser-vation group was additionally treated with Urinary kallidinogenase for injection 0.15 PNA unit adding into Sodium chloride injec-tion 100 ml by intravenous injection,once a day. The treatment course for both groups was 2 weeks. The clinic data was observed, including clinical efficacy,and LDL,HDL TC and TG levels before and after treatment,recurrence rate of cerebral ischemia,inci-dence of cerebral infarction and adverse reactions after 6 months of follow-up. RESULTS:The total effective rate in observation group was significantly higher than control group,and the recurrence rate of cerebral ischemia and incidence of cerebral infarction were significantly lower than control group(P<0.05). After treatment,HDL level in 2 groups were significantly higher than be-fore,and observation group was higher than control group;levels of LDL,TC and TG were significantly lower than before,and observation group was lower than control group(P<0.05). There were no severe adverse reactions in groups during treatment. CON-CLUSIONS:Triple therapy of aspirin,clopidogrel and urinary kallidinogenase has significant efficacy in the treatment of transient ischemic attack,with good safety.
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Objective To observe the efficacy of urinary kallidinogenase plus batroxobin in the treatment of acute cerebral infarction.Methods 105 patients with acute cerebral infarction were selected and divided into 3 groups:urinary kallidinogenase group (35 cases),combined treatment group (39 cases),batroxobin group (31 cases).The NIHSS score,Barthel Index,MRS score were evaluated before treatment and 10 days after treatment,and the clinical efficacy was compared.Results The NIHSS score significantly decreased after treatment in the three groups (all P ＜ 0.05).The effective rate of combined treatment group was better than that of the single treatment group (urinary kallidinogenase group or batroxobin group) [79.5 ％ (31/39),71.4 ％ (25/35),35.4％ (11/31) (x2 =15.801,P =0.001)].The Barthel Index and MRS score of combined treatmentgroup were better than those of the batroxobin group (P =0.003),not better than the urinary kallidinogenase group (P =0.766).Conclusion Urinary kallidinogenase plus batroxobin is effective in the treatment of acute cerebral infarction.
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Objective To observe the effect of Xueshuantong combined with Urinary Kallidinogenase on acute cerebral infarction in middle-aged and aged people.Methods 120 patients with acute cerebral infarction were randomly divided into two groups,the treatment group was given 400mg Xueshuantong with 0.15PNA of Urinary Kallidinogenase,while the control group was only given 400mg Xueshuantong.After treatment for 2 weeks,the nerve function deficit score and the curative effect were compared between two groups.Results The curative effect of treatment group and control group was 91.7％ and 71.7％,respectively.The nerve function deficit score in two groups was decreased than before treatment,the difference between two groups was significant (P ＜ 0.05).Conclusion The effect of Xueshuantong combined with Urinary Kallidinogenase in treatment of acute cerebral infarction in middle-aged and aged people was confirmed with high safety and low side effects,which worthy of clinical application.
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Objective To explore the effect and safety of urinary kallidinogenase combined with edaravone in treating moderate and severe acute cerebral infarction.Methods 84 patients who had acute cerebral infarction were randomly divided into 2 groups,control group was given edaravone,treatment group was added urinary kallidinogenase based on control group,other conventional medical treatments were same.Results After 14 days treatment,the change of National Institute of Health stroke scale(NIHSS)and Activities of Daily Living(ADL)before and after the 14 days were compared.After the treatment,NIHSS of urinary kallidinogenase group and control group both improved (P ＜ 0.01),urinary kallidinogenase group improved more significantly,and had significant difference compared with control group(P ＜ 0.01).ADL level of the two groups both went up(P ＜ 0.01),urinary kallidinogenase group went up more significantly,and had the significant difference compared with controlled group(P ＜ 0.01).Conclusion Uri nary kallidinogenase could selectively expand ischemic vessel,open collateral circulation,and promote the formation of new vessels,if combined with edaravone treating moderate and severe acute cerebral infarction,it could significantly improve the neurological deficit,reduce disability rate and increase the safety.
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ObjectiveTo investigate the effect of urinary kallidinogenase for injection on neurological function and serum matrix metalloproteinase 9(MMP-9) in patients with cerebral infarction.Methods Ninety patients of acute cerebral infarction were divided into observation group and control group by random digits table with 45 cases each.The control group was treated with conventional therapy.The observation group was treated with conventional therapy and additional urinary kallidinogenase for injection treatment,0.15 PNA U/day,for 10 days.National institutes of health stroke scale(NIHSS) score and Barthel index (BI) score were used to evaluate the neurological impairment and the abilities of activities of daily living.The serum MMP-9 levels was tested by enzyme linked immunosorbent assay.The treatment outcome,NIHSS score,BI score and serum MMP-9 level were compared.ResultsThe total effective rate in observation group [ 88.9％ (40/45) ] was higher than that in control group [ 71.1％ (32/45) ],and there was significant difference (P ＜ 0.05).NIHSS score after 3 months treatment was decreased and BI score was increased compared with before treatment in two groups,and there were significant differences(P＜ 0.05).NIHSS score after 3 months treatment in observation group[ (6.56 ± 0.74) scores] was lower than that in control group [ (9.06 ± 0.87 ) scores ],and there was significant difference (P ＜ 0.05 ).BI score after 3 months treatment in observation group [ (79.98 ± 7.32) scores ] was higher than that in control group [ (72.57 ± 6.95 ) scores ],and there was significant difference(P ＜ 0.05).Compared with before treatment,the serum MMP-9 level after 10 days treatment was significantly decreased in two groups (P＜ 0.05 ).The serum MMP-9 level after 10 days treatment in observation group[ ( 187.58 ± 14.52) ng/L] was lower than that in control group[ (238.89 ± 17.48 ) ng/L ] with significant difference (P ＜ 0.05 ).ConclusionsUrinary kallidinogenase for injection can significantly improve neurological function in patients with cerebral infarction,significantly decrease serum MMP-9 levels.It has good effect and high clinical value.
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Objective To investigate the effect and safety of urinary kallidinogenase on acute cerebral infarction.Methods One hundred and sixty-four patients with acute cerebral infarction were randomly divided into two groups:treatment group with urinary kallidinogenase(86 cases)and control group (78 cases).According to Chinese guidelines for prevention and management cerebrovascular disease,two groups were treated with basic therapy,such as antiplatelet,neurologic protection,blood pressure control,and so on.On basis of control group,treatment group Was administrated intravenous injection of urinary kallidinogenase 0.15 PNA U per day for 10 days.The primary efficacy Was evaluated by the National Institutes of Health Stroke Scale(NIHSS)score and Barthel index.Results The score of NIHSS and Barthel index at 15 days after treatment in the treatment group were higher than those in the control group[(6.67±3.02)scores vs(7.42±3.02)scores;75.36±23.56 vs 68.36±22.36,P＜0.05].Urinary kallidinogenase could significantly reduce neurological deficits in big artherosclerosis type by TOAST typing.Conclusion Urinary kallidinogenase may be effective and safe in the treatment of acute cerebral infarction.