The Effect Of Human Urinary Kallikrein On Corticospinal Tract Injury In Acute Ischemia Stroke Patients

Objective: To evaluate of the effect of human urinary kallikrein on corticospinal tract injury in ischemia stroke patients.Methods:Seventy-five patients with acute cerebral infarction were enrolled in this study who hospitalized in the Department of Neurology,Second Hospital of Hebei Medical University from July 2017 to December 2018.And all patients were divided into two groups according to the random number table method.The experimental group was given human urinary kallikrein through intravenous injection to treatment for conventional dose+standard treatment medicine based on the guideline;the control group was only given standard treatment medicine based on the guide,and both groups were treated for 14 ± 5 days.Two diffusion tensor imaging(DTI)scans were performed within 3 days of onset and 14±5 days after treatment,and anisotropic fraction(FA)and apparent diffusion coefficient(ADC)values were obtained.Results:There was no significant difference in clinical baseline data between the experimental group and control group(P>0.05).Logistic regression analysis showed that the grade of diffusion tensor tractography(DTT)of corticospinal tract injury had a statistically significance with the difference of muscle strength and motor function scores after treatment(P<0.05).The difference of FA decline rate was significantly correlated with the difference of NIHSS score before and after treatment(P<0.05).The difference of ADC decline rate was significantly correlated with the difference of mRS before and after treatment(P<0.05).Spearman correlation analysis showed that the DTT classification had a moderate negative correlation with the drop-out of BI index(r=-0.543,P=0.000)and mRS(r=-0.550,P=0.000),and a low negative correlation with the drop-out of muscle strength,a weak negative correlation with the drop-out of NIHSS score(r=-0.260,P=0.024).There were significant differences in the NIHSS score difference,BI index difference,muscle strength difference,the difference of FA decline rate and ADC decline rate after 14±5 days of kallikrein treatment(P<0.05).Conclusions:The integrity of corticospinal tract is closely related to the recovery of limb motor function.Human urinary kallikrein may have a protective effect on corticospinal tract injury in ischemia stroke which may be one of the mechanisms of HUK effectiveness on acute cerebral infarction.