机械取栓辅助动脉内溶栓对急性缺血性脑卒中患者的疗效和颅内血流动力学、神经损伤标志物的影响  

Efficacy Evaluation of Mechanical Thrombolysis Assisted Intra-arterial Thrombolysis in Acute Ischemic Stroke and Its Effect on Intracranial Hemodynamics and Neurological Injury Markers

作　　者：智孔亮[1] 卢丽敏[1] 田磊 王天罡 林杰[1] 武一平[1] 辛娜[1] ZHI Kong-liang;LU Li-min;TIAN Lei;WANG Tian-gang;LIN Jie;WU Yi-ping;XIN Na(Department of Psychiatry,Handan First Hospital,Handan 056002,China)

机构地区：[1]邯郸市第一医院神内一科

出　　处：《微循环学杂志》2019年第4期26-30,共5页Chinese Journal of Microcirculation

基　　金：河北省医药卫生计划课题(20130430)

摘　　要：目的:评价机械取栓辅助动脉内溶栓对急性缺血性脑卒中的疗效及对患者颅内血流动力学和神经损伤标志物的影响。方法:回顾性分析本院2015-06-2017-12收治的86例急性缺血性脑卒中患者资料,根据不同治疗方式分为对照组(41例)和观察组(45例),对照组采用动脉内溶栓治疗,观察组采用机械取栓辅助动脉内溶栓治疗,比较两组血管再通情况、治疗前后颅内血流动力学指标水平、神经损伤标志物、美国国立卫生研究院卒中量表(NIHSS)评分、并发症和预后情况。结果:观察组血管再通率、恢复良好率均高于对照组(P<0.05)。治疗后,两组最大峰值流速(Vs)、平均流速(Vm)均较治疗前上升,血管阻力指数(RI)、血管搏动指数(PI)、血清谷氨酸(Glu)、神经元特异性烯醇化酶(NSE)、S100β蛋白水平及NIHSS均较治疗前下降,且观察组改善情况均优于对照组(P<0.01)。两组不良反应总发生率比较无统计学差异(P>0.05)。结论:机械取栓辅助动脉内溶栓对急性缺血性脑卒中患者疗效优于单纯动脉内溶栓治疗。Objective:To evaluate the efficacy of mechanical thrombolysis assisted intra-arterial thrombolysis in acute ischemic stroke and its effect on intracranial hemodynamics and neurological injury markers.Method:86patients with acute ischemic stroke admitted to our hospital from June 2015to December 2017,according to the different treatment were divided into 41cases of control group and 45cases of observation group,control group was treated with intra-arterial thrombolysis,observation group was treated with mechanical thrombectomy for intra-arterial thrombolysis,the recanalization,intracranial hemodynamics,the nerve damage markers,the United States national institutes of health stroke scale(NIHSS)scores before and after the treatment,complications and prognosis in both group were compared.Results:The vascular recanalization rate and recovery rate in the observation group was higher than that in the control group(P<0.05).After treatment,maximum peak flow velocity(Vs),mean velocity(Vm)in both group were rised than before treatment,the observation group was higher than the control group,vascular resistance index(RI),blood vessels,pulsation index(PI),serum levels of glutamic acid(Glu),neuron specific enolization enzyme(NSE),S100βprotein and NIHSS in both group were decreased than before treatment,the observation group was lower than the control group,there were statistically significant differences(P<0.05).There was no statistical difference of total complication rate between the two groups(P>0.05).Conclusion:Mechanical thrombolysis assisted intra-arterial thrombolysis can improve the rate of vascular recanalization,improve intracranial hemodynamics,reduce the markers of nerve injury,and improve the prognosis.

关 键 词：急性缺血性脑卒中 机械取栓 动脉内溶栓 疗效 颅内血流动力学 神经损伤标志物 

分 类 号：R743.33[医药卫生—神经病学与精神病学]