阿替普酶对急性脑梗死疗效及其对神经功能损伤程度、实验室指标影响  

Effect of acipsin on acute cerebral infarction and its effect on the degree of nerve function injury and laboratory index

作　　者：董亚茹[1] 薛秀云 韩彩萍[1] 张琳[1] 顾乃兵[1] DONG Yaru;XUE Xiuyun;HAN Caiping;ZHANG Lin;GU Naibing(Department Neurology,Departmentmy,the Central Hospital of Xi＇an,Xi＇an 710003,China)

机构地区：[1]西安市中心医院神经内科,710003

出　　处：《疑难病杂志》2018年第8期771-775,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：陕西省教育厅科学研究计划项目(14JK1614)

摘　　要：目的观察阿替普酶治疗急性脑梗死的疗效及对其神经功能损伤程度、实验室指标的影响。方法选择2016年11月-2017年8月西安市中心医院神经内科收治的66例急性脑梗死患者作为研究对象,随机数字表法分为观察组和对照组,每组33例。对照组常规治疗,观察组在常规治疗基础上加用阿替普酶溶栓治疗,比较2组患者治疗后的临床疗效、神经功能损伤、凝血功能指标、炎性反应指标。结果 2组患者治疗前神经功能损伤、凝血功能指标、炎性反应指标以及NIHSS评分、Barthel指数评分差异不显著(P>0.05)治疗后观察组总有效率明显高于对照组(90.91%vs.63.64%,χ~2/P=6.988/0.008),S100β、神经元特异性烯醇化酶(NSE)、胶质纤维酸性蛋白(GFAP)、凝血因子Ⅷ(FⅧ)、血管性血友病因子(vWF)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)、肿瘤坏死因子(TNF-α)、白介素-1β(IL-1β)、高敏C反应蛋白(hs-CRP)以及NIHSS评分明显低于对照组(t/P=17.769/<0.01、16.626/<0.01、15.940/<0.01、15.310/<0.01、22.218/<0.01、5.427/<0.01、11.455/<0.01、13.652/<0.01、18.254/<0.01、8.104/<0.01、6.839/<0.01),PT以及Barthel指数评分明显升高(t/P=11.314/<0.01、7.004/<0.01)。结论阿替普酶治疗急性脑梗死患者可增强临床疗效、减轻炎性反应,改善凝血功能以及神经功能损伤,提高生活质量。Objective To observe the effect of alteplase in treating acute cerebral infarction and the degree of neurological impairment, and the influence of laboratory parameters. Methods From November 2016 to August 2017,66 patients with acute cerebral infarction who were admitted to the Department of Neurology of Xi＇ an Central Hospital were selected as study subjects. They were randomly divided into observation group and control group, with 33 cases in each group. The control group received routine treatment. The observation group was treated with alteplase thrombolytic therapy on the basis of routine treatment in the control group. The clinical efficacy, neurological impairment, coagulation function index, and inflammatory response index were compared between the two groups after treatment. Results The corresponding neurological impairment, coagulation function index, inflammatory response index, NIHSS score and Barthel index score before treatment were not significantly different between the two groups（t/P =0. 439/0. 331, t/P =0. 058/0. 477, t/P =0. 387/0. 350, t/P =0.226/0.411,t/P= 0.529/0. 299, t/P=0. 061/0. 476,t/P=0. 082/0. 468, t/P = 0. 146/0.442, t/P=0. 111/0.456,t/P=0.040/0. 484,t/P=0. 049/0.481, t/P=0. 048/0. 481, t/P =0. 043/0. 483）. Compared with the control group, the total effective rate in the observation group was significantly improved（ 90. 91 % vs. 63. 64%, χ^2/P=6.988/0. 008）,S100（3, NSE, GFAP, FVIII, VWF, APTT, TT, TNF-α, IL-1β, hs-CRP, NIHSS score were significantly lower（t/P=17.769/0.00, t/P = 16. 626/0. 00, t/P = 15. 940/0. 00, t/P = 15. 310/0. 00, t/P = 22. 218/0. 00, t/P = 5. 427/0. 00.t/P = 11. 455/0. 00, t/P = 13. 652/0.00, t/P = 18. 254/0. 00,t/P=8. 104/0. 00, t/P = 6. 839/0. 00）, the scores of PT and Barthel index increased significantly（t/P=11. 314/0. 00, t/P = 7. 004/0. 00）. Conclusion Alteplase treatment of patients with acute cerebral infarction can enhance clinical efficacy, reduce inflammatory reactions, improve coagulation and neurological function damage, and i

关 键 词：阿替普酶 脑梗死 急性 神经功能 实验室指标 

分 类 号：R743.33[医药卫生—神经病学与精神病学]