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The Role of Fibrinogen-depleting Therapy in the Second Prevention of Ischemic Stroke

Author: LiRuiXia
Tutor: LiuChunFeng;CaoYongJun
School: Suzhou University
Course: Neurology
Keywords: Ischemic stroke Lumbrokinase Fibrinogen Carotid atherosclerosis Neurological score Vascular events Clinical research
CLC: R743.3
Type: Master's thesis
Year: 2010
Downloads: 28
Quote: 0
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Abstract


Objective To observe the plasma fibrinogen levels after long-term oral lumbrokinase defibrase treatment of ischemic stroke patients and patients with carotid atherosclerosis and vascular event incidence; evaluation of oral defibrase therapy in ischemic stroke secondary prevention in patients with the role. Multi-center, parallel, controlled trials, select the the Suzhou area 11 hospitals from 2007 to 2009 hospitalized patients with ischemic stroke, selected patients were divided into two groups, the control group received conventional treatment of the Department of Neurology, the experimental group On this basis, plus lumbrokinase 60 million units, orally, three times a day for 1 year follow-up observation. Were detected on admission and 1 year after treatment the level of plasma fibrinogen (Fg); using color Doppler were recorded before and after treatment of carotid plaque diameter, wide diameter, number, location of the echo intensity, carotid artery intima-media thickness (IMT) and carotid artery wall inner diameter of indicators, and the detection rate of plaque, plaque volume and vulnerable plaque detection rate calculated based on the ultrasound results; recorded before and after treatment of neurological deficit (NIHSS) score In addition, before and after treatment of plasma C-reactive protein (CRP), fibrinolysis (t-PA, PAI-1 and D-dimer); calculated after treatment of vascular events; coagulation parameters, blood rheology indicators and other changes in the project. The results finally included 310 patients (test group of 192 patients in the control group of 118 cases). The test group before and after treatment Fg left and right carotid IMT, the left and right carotid artery plaque volume changes in carotid vulnerable plaque detection rate, NIHSS and vascular event incidence was statistically significant (P lt; 0.05). Compared with the control group, the experimental group Fg, the left and right carotid IMT after 1 year of treatment, the left and right carotid artery plaque volume, carotid vulnerable plaque detection rate and changes in the NIHSS was statistically significant (P lt; 0.05) . The mean carotid plaque volume and plaque diameter, width, number of carotid IMT and whole blood viscosity was significantly correlated (P lt; 0.01), weakly correlated with plasma fibrinogen level (P = 0.056). The conclusion of ischemic stroke in patients with long-term oral lumbrokinase drop fiber treatment can effectively reduce plasma fibrinogen, D-dimer and CRP levels, increased plasma fibrinolytic activity, improve carotid atherosclerosis and improve neurological function in patients prognosis and effectively reduce the incidence of total vascular events, and cerebrovascular events.

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CLC: > Medicine, health > Neurology and psychiatry > Neurology > Cerebrovascular disease > Acute cerebrovascular disease ( stroke)
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