急性脑梗死患者介入治疗的疗效及对患者纤溶系统的影响  

Clinical Effect of Interventional Therapy on Acute Cerebral Infarction and its Impact on the Fibrinolytic System

作　　者：董先成 郎清[1] 陈忠[1] 蔡洪[1] 赵龙[2] 

机构地区：[1]四川省达州市中心医院神经外科,四川达州635000 [2]川北医学院附属医院神经外科,四川南充637000

出　　处：《现代生物医学进展》2015年第15期2900-2903,共4页Progress in Modern Biomedicine

摘　　要：目的:研究急性脑梗死患者脑血管球囊成形支架置入术治疗的临床疗效及其对患者纤溶系统的影响。方法:选择我院收治的急性脑梗死患者68例,随机分为观察1组和观察2组,各34例,观察1组给予尿激酶100万U静脉溶栓治疗;观察2组给予脑血管球囊成形支架置入术治疗,术后口服氯吡格雷和阿司匹林。观察两组患者治疗前、治疗后1d、7d组织型纤溶酶原激活物(t PA)、血浆血管性假血友病因子(v WF)、纤溶酶原激活物特异性抑制物(PAI-1)水平,并选择同期体检健康者30例作为对照组。结果:治疗后观察2组血流再通明显高于观察1组(P<0.05);治疗前所有患者v WF、PAI-1、t PA明显高于对照组,t PA/PAI-1明显低于对照组(P<0.05),但观察1组和观察2组比较无统计学差异(P>0.05);治疗后1d观察1组、观察2组t PA、t PA/PAI-1明显升高,PAI-1明显降低(P<0.05),治疗后7d,观察1组t PA、t PA/PAI-1明显降低,观察2组v WF明显升高(P<0.05)。结论:脑血管球囊成形支架置入术治疗急性脑梗死可使梗死的血管再次通畅,术后采用抗凝及抗血小板治疗,效果显著,且对体内纤溶系统无明显影响,相比静脉溶栓治疗临床效果更加显著。Objective： To investige the clinical effect of cerebral vascular angioplasty and stenting in acute cerebral infarction and its impact on the fibrinolytic system. Methods： 68 patients of acute cerebral infarction in our hospital were randomly divided into observation group 1 and observation group 2, each of 34 cases, observation group 1 were given 1 000 000 U ofurokinase; observation group 2 group were given cerebral vascular angioplasty and stenting for the treatment of postoperative oral clopidogrel, aspirin. The plasma von Willebrand factor （vWF）, tissue type plasminogen activator （tPA）, plasminogen activator inhibitor （PAI-1） level were detected before treatment and 1 d, 7 d after the treatment.And selected 30 cases healthy persons as control group. Results： The reperfusion of observation group 2 was significantly higher than that of observation group （P〈0.05）. Before treatment, the vWF, PAl-1, tPA of all patients were sig- nificantly higher than those in control group, tPA/PAI-1 was significantly lower than that of the control group （P〈0.05）, but there was not statistically significant between observation group 1 and 2（P〉0.05）. ld after treatment, the tPA, tPA/PAI-1 increased in observation group 1 and 2 group, PAI-1 decreased significantly （P〈0.05）, 7d after treatment, the tPA, tPA/PAI-1 of observation group.1 decreased signifi- cantly, the vWF of observation group 2 was significantly increased （P〈0.05）. Conclusion： Cerebral vascular angioplasty and stenting for the treatment of acute cerebral infarction can make the reperfusion of infarct related artery and have little effect on fibrinolytic system,the clinical effect is better than that of intravenous thrombolytic therapy.

关 键 词：脑梗死 介入治疗 纤溶凝血系统 静脉溶栓 

分 类 号：R743[医药卫生—神经病学与精神病学]