Human Urinary Kallidinogenase Improves Outcome of Stroke Patients by Shortening Mean Transit Time of Perfusion Magnetic Resonance Imaging
Human Urinary Kallidinogenase Improves Outcome of Stroke Patients by Shortening Mean Transit Time of Perfusion Magnetic Resonance Imaging
复制标题
人尿激肽原酶通过缩短灌注磁共振成像的平均传输时间来改善中风患者的预后
DOI：
10.1016/j.jstrokecerebrovasdis.2015.03.032
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发表时间：
2015-08-01
影响因子：
2.5
通讯作者：
Xu, Yun
中科院分区：
文献类型：
--
作者：
Li, Jingwei;Chen, Yan;Xu, Yun
背景：改善脑灌注仍然是缺血性卒中恢复脑血流的一个很好的选择。人尿激肽原酶已被证明在治疗脑卒中患者方面具有前景。探讨尤瑞克林治疗脑卒中的疗效是否与改善脑灌注有关及可能的机制。方法：对58例南京鼓楼医院脑卒中患者进行前瞻性研究。其中29例接受人尿激肽原酶治疗，另29例作为对照。采用美国国立卫生研究院卒中量表、改良兰金量表和日常生活活动能力评分确定患者结局。通过灌注磁共振成像确定患者的脑灌注。酶联免疫吸附法测定血清apelin和血管内皮生长因子。结果：我们证实人尤瑞克林原酶改善了患者的卒中预后。治疗后12天，人尿激肽原酶升高脑灌注。人尿激肽原酶增强中风患者血管内皮生长因子和APJ的表达。通过单变量logistic回归分析，平均通过时间的减少与有利的结局相关。结论：人尿激肽原酶通过上调血管内皮生长因子apelin/APJ通路促进脑卒中恢复和脑再灌注。
Background: Improving cerebral perfusion remains a good option for ischemic stroke for restoring cerebral blood flow. Human urinary kallidinogenase has been shown promising in treating stroke patients. To investigate whether human urinary kallidinogenase's efficacy in treating stroke patients has relationship with improving cerebral perfusion and possible mechanism. Methods: Fifty-eight stroke patients in Nanjing Drum Tower Hospital were enrolled in this prospective study. Of them, 29 received human urinary kallidinogenase, while the other 29 were selected as control. National institute health stroke scale, modified Rankin Scale and activities of daily living score were used to determine patient outcome. Cerebral perfusion in patients was determined by perfusion magnetic resonance imaging. Serum apelin and vascular endothelial growth factor were measured by enzyme-linked immunosorbent assay. Results: We confirmed that human urinary kallidinogenase improved stroke outcome in patients. Cerebral perfusion was elevated by human urinary kallidinogenase 12 days after therapy. Human urinary kallidinogenase enhanced vascular endothelial growth factor and APJ expression in stroke patients. The reduced mean transit time was related with favorable outcome analyzed by univariate logistic regression. Conclusions: Human urinary kallidinogenase facilitated stroke recovery and enhanced cerebral reperfusion through up-regulating vascular endothelial growth factor, apelin/APJ pathway.