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目的研究藻酸双酯钠治疗急性脑梗死的抗血小板作用及临床疗效。方法将发病半月内的急性脑梗死患者随机分为藻酸双酯钠(PSS)、阿司匹林(ASA)与噻氯匹啶(TP)等3组,观察治疗前后的血小板聚集率(PAg T)、凝血酶原时间(PT)、活化部分凝血活酶时间(aPTT)、凝血酶时间(TT)、血浆纤维蛋白原(Fbg)、血清脂质的改变,并观察治疗前后临床神经功能状况。结果(1)PSS 对 ADP 与花生四烯酸(AA)诱导的 PAg T 均有一定的抑制作用,而 ASA 对 AA 诱导的 PAg T 作用更显著,TP 主要抑制 ADP 诱导的 PAg T。(2)PSS 延长 aPTT,对 PT 仅3d 时有延长．对 TT 与 Fbg 作用不大。ASA、TP 对以上指标均无影响。(3)PSS 有明显降脂效果,而 ASA、TP 无此作用。(4)PSS 组患者神经功能恢复优于 ASA 与 TP 组。结论 PSS 具有降脂、抗凝作用,并具有一定的抗血小板作用,能在多个环节上发挥抗血栓作用,有效改善急性脑梗死患者神经功能缺损症状,并提高其日常生活能力。
Objective To study the anti-platelet effect and clinical efficacy of sodium alginate in the treatment of acute cerebral infarction. Methods Patients with acute cerebral infarction within half a month of onset were randomly divided into three groups: sodium alginate (PSS), aspirin (ASA) and ticlopidine (TP). The levels of platelet aggregation (PAg T) Prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (TT), plasma fibrinogen (Fbg), serum lipid changes, and clinical neurological function before and after treatment. Results (1) PSS inhibited PAg T induced by ADP and arachidonic acid (AA), while ASA had more significant effect on PAg T induced by AA. TP inhibited ADP-induced PAg T. (2) PSS extended aPTT, PT only 3d extended. Little effect on TT and Fbg. ASA, TP have no effect on the above indicators. (3) PSS has a significant lipid-lowering effect, while ASA, TP no such effect. (4) PSS patients had better neurological recovery than ASA and TP groups. Conclusion PSS has lipid-lowering and anticoagulant effects and has certain anti-platelet effect. It can exert antithrombotic effect in many aspects and effectively improve the symptoms of neurological deficits and improve the daily living ability of patients with acute cerebral infarction.