Clinical Study Of Defibrase Therapy Based On The Level Of Plasma Fibrinogen In The Patients With Acute Cerebral Infarction

Objectives:To explore the therapeutic effect of individualized defibrase therapy, We administered to the patients with acute cerebral infarction(ACI) of differential dosage of defibrase according to the level of plasma fibrinogen(FIB).Methods:60 patients with acute cerebral infarction(onste within 72h) were randomly divided into 2 groups:defibrase group(n=30) and control group(n=30).The patients in defibrase group were intravenous drip different first dosage(15U,10U,5U) of defibrase according to the level of plasma FIB(>4g/L,2-4g/L,1.3-2g/L )before treatment.We detected the level of plasma FIB of the patients q12h after the first administration of defibrase.when the level of plasma fibrinogen>1.3g/L,the patients were intravenous drip defibrase again and the range(0.70-1.13g/L)of plasma FIB were being maintained for 7 days. We detected all the patients'plasma prothrombin time(PT),activated partial thromboplastin time(APTT) and fibrinogen(Fg) before treatment and after 7 days of treatment,then evaluated the clinical therapeutic effect through the scores of Chinese stroke scal(eCSS)after 14 days of treatment and Activity of daily living(ADL) after 3 months of treatment.Results:1. After 7 days of treatment,plasma PT and APTT lengthened,plasma Fg lowered in defibrase group.There was significant difference comgparing before treatment with after 7 days of treatment.2. The scores of CSS improved in defibrase group after 14 days of treatment. Comparing before treatment and after treatment in defibrase group,there was significant difference,and there was significant difference between defibrase group and control group.3. Clinical therapeutic effectiveness was 80% in defibrase group and 50% in control group, the differences between defibrase group and control group was significant.4. Defibrase group and control group were not significant difference in the scores of ADL after 3 months,but the proportion of independent living and mild dependency was 93.3% in defibrase group and 70.0% in control group, there was significant difference between them.5. In defibrase group there was no case of intracerebral and extracerebral haemorrhage during treatment and no case of death after 3 months of treatment.Conclusion:The defibrase therapy based on the level of plasma FIB in the patients with ACI can quickly and placidly lower the level of plasma FIB,reduce neurologic impairment and improves life quality. The individualized treatment of defibrase is effective and safe.