静脉溶栓联合亚低温治疗对急性脑梗死患者的临床疗效与机制研究  

Effect of Intravenous Thrombolysis combined with Mild Hypothermia on Acute Cerebral Infarction and Its Possible Mechanism

作　　者：裴小利[1] PEI Xiao-li(Department of Neurology,Yangcheng People's Hospital,Jincheng 048100,China)

机构地区：[1]山西省阳城县人民医院神经内科

出　　处：《中国医药指南》2018年第36期6-8,共3页Guide of China Medicine

摘　　要：目的探讨静脉溶栓联合亚低温治疗对急性脑梗死患者疗效及可能作用机制的研究。方法选取我院(2016年5月至2018年8月)收治的急性脑梗死患者120例为研究对象,均经临床检查确诊,根据不同治疗方法分为三组,对照组(n=40)给予静脉溶栓治疗,观察组Ⅰ(n=40)在对照组基础上给予12 h头部亚低温治疗,观察组Ⅱ(n=40)在对照组基础上给予24 h头部亚低温治疗,对比三组患者临床疗效和治疗前后神经功能、脂质氧化(MDA)水平、超氧化物歧化酶(SOD)水平以及独立生活能力。结果治疗后24 h、72 h、7 d、14d三组患者NIHSS评分均明显低于治疗前,差异具有统计学意义(P<0.05);治疗后三组患者NIHSS评分对比差异不明显,无统计学意义(P>0.05)。治疗后72 h、7 d对照组患者MDA水平明显下降,SOD水平明显升高,差异具有统计学意义(P<0.05);治疗后24 h、72 h、7 d观察组Ⅰ、Ⅱ患者MDA水平明显下降,SOD水平明显升高,且与对照组相比也存在显著差异,具有统计学意义(P<0.05);观察组Ⅱ患者治疗后72 h、7 d MDA水平明显低于观察组Ⅰ,治疗后7 d SOD水平明显高于观察组Ⅰ,差异具有统计学意义(P<0.05)。观察组Ⅰ、Ⅱ患者治疗后3个月mRS评分明显低于对照组,差异具有统计学意义(P<0.05);观察组Ⅱ患者m RS评分明显高于观察组Ⅰ,差异具有统计学意义(P<0.05)。三组患者病死率与不良反应发生率对比差异具有统计学意义(P<0.05)。结论静脉溶栓联合亚低温治疗对急性脑梗死患者疗效满意。Objective To investigate the effect and possible mechanism of intravenous thrombolysis combined with mild hypothermia on acute cerebral infarction.Methods 120 patients with acute cerebral infarction admitted to our hospital from May 2016 to August 2018 were selected as the research objects.All patients were diagnosed by clinical examination.They were divided into three groups according to different treatment methods.The control group(n=40)was treated with intravenous thrombolysis.The observation groupⅠ(n=40)was treated with mild hypothermia for 12 hours on the basis of the control group.GroupⅡ(n=40)was treated with mild hypothermia for 24 hours on the basis of the control group.The clinical efficacy,neurological function,lipid oxidation(MDA),superoxide dismutase(SOD),independent living ability of the three groups were compared before and after treatment.Results:The NIHSS scores of the three groups at 24 hours,72 hours,7 days and 14 days after treatment were significantly lower than those before treatment(P<0.05),and there was no significant difference between the three groups after treatment(P>0.05).The levels of MDA and SOD in the control group were significantly lower than those in the control group 72 hours and 7 days after treatment(P<0.05),and the levels of MDA and SOD in the observation groupⅠandⅡwere significantly lower than those in the control group 24 hours,72 hours and 7 days after treatment(P<0.05).The level of MDA in observation groupⅡwas significantly lower than that in observation groupⅠ72 hours and 7 days after treatment,and the level of SOD was significantly higher than that in observation groupⅠ7 days after treatment(P<0.05).The mRS scores of patients in observation groupⅠandⅡwere significantly lower than those in control group 3 months after treatment(P<0.05),while those in observation groupⅡwere significantly higher than those in observation groupⅠ(P<0.05).The difference between the mortality rate and the incidence of adverse reactions between the three groups was statist

关 键 词：静脉溶栓 亚低温治疗 急性脑梗死 作用机制 

分 类 号：R743.3[医药卫生—神经病学与精神病学]