Observation Of Curative Effect On Plasmin Treatment In Patients Suffered From Acute Cerebral Infarction With An Exceeding Time Window Of Thrombolysis

Objective:1.To make observation on the changes and adverse effects during treatment of the patient's indexes such as National Institution of Health Scale Score(NIHSS),the BI score for activities daily living(ADL),the activated partial thrombin time(APTT),fibr-inogen,prothrombin time(PT),who suffers from acute cerebral infarction with an exceeding time window of thrombolysis.2.To make a deep understanding of the efficacy and safety of plasmin treatment in patients who suffer from acute cerebral infarction with an exceeding time window of thrombolysis through observing the changes of the above indexes.3.Make observations on the changes of the above indexes after a treatment of plasmin injection,it is speculated that the possible mechanism about plasmin injection how to play a role in thrombosis and preventing thrombus from an advanced progress.Methods:A total of 121 patients admitted to the Department of Neurology,HuBei MinZu university attached Hospital from December 2016 to June 2018 were selected as reseairch objects who have clarified a diagnosis of acute cerebral infarction with a disease time exceeding the time windows of thrombolysis.All the patients are separated into two group randomlyt,where 60 patients were take as the control group for conventional therapy and the rest 61 patients were take as observing group for the plasmin dose treatment.The basic treatments such as improved blood circulation,prevention aggregation of platelet,reducing blood fat,neuro protection and other symptomatic supportive treatments.The observation group was given a plasmin injection within 24 hours after the patients had received a definite diagnosis(plasmin injection 200 IU + 500 mL 0.9%sodium chloride injection,intravenous drip,once a day)on the basis of the treatment for control group.The course for both groups lasted for 14 days.Before the treatment for the two groups of patients,there was no difference of statistical significance when the basic data of patients in two groups were compared with each other,(P>0.05).The scoring of NIHSS,the barb index(BI)score for activities of daily living were carried out for both groups before the treatment,and on the seventh days and ninth days of the treatment during which time the the index of coagulation function was also inspected:the changes of activated partial thrombin time(APTT),prothrombin time(PT)and the fibrinogen(FIB)values.Make an observation and recording on the situation of patients after treatment of their clinical efficacy,subcutaneous hemorrhage,bleeding status of the puncture site,mucosal oozing,gastrointestinal bleeding,occult urination and defecation bleeding and cerebral hemorrhage.Make an observation of adverse reactions of the affected limbs and head pain,fever,sweating,etc.,and carried out a statistical analysis of the recorded results.Results:1.There was no significant difference in gender,age,disease time,history of hypertension,history of diabetes,history of cardiovascular disease,blood pressure,NIHSS,BI score,APTT,PT and FIB between the two groups before treatment(P>0.05).2.On the 7th day of treatment,there was a rising for the values of APTT and PT in the observation group colmpared to those of the control group;while the scores of NIHSS and FIB value in observing group were lower than the control group,and the difference for all the indexes between the two groups were statistically significant(P<0.05).The BI score of the observation group was higher than that of the control group,but there was no statistical difference(P<0.05).There was difference of statistical significance in the indexes of NIHSS score,BI score,APTT,FIB,and PT values of the patients in two groups compared to those indexes before treatment(P<0.05).3.On the 14th day of treatment,the total effective rate of the observation group(98.36%)was higher than that of the control group(88.33%),with statistical difference(P<0.05).4.On the 14th day of treatment,the BI score,APTT and PT values of the observation group were higher than those of the control group with a difference of statistical significance(P<0.05).The NIHSS score and FIB value were lower than the control group with a difference of statistical significance(P<0.05).The BI scores,APTT and PT values of the patients in each groups compared externally with the data before the treatment were further increased,while the NIHSS score and FIB value were further decreased compared externally with the data before treatment,and the differences of each index were statistical significance(P<0.05).5.There were no bleeding complications and obvious adverse reactions for both groups during the treatment period.Conclusion:For patients who suffer from acute cerebral infarction with an exceeding time window of thrombolysis,they can be treated on the basis of conventional therapy with the addition of plasmin treatment.It has a significant curative effect,which can significantly improve the symptoms of neurological deficits,promote the ability of activities for daily living,and effectively reduce the plasma fibrinogen of patients with a higher safety level.