阿替普酶联合丁苯酞治疗急性脑梗死的效果及对炎性因子、血流动力学指标的影响  

Therapeutic Effect of Ateplase Combined with Butylphthalide on Acute Cerebral Infarction and Its Influence on Inflammatory Factors and Hemodynamic Parameters

作　　者：范磊[1] 刘星亮[1] 岳秉宏[1] 潘妍婷[1] FAN Lei;LIU Xing-liang;YUE Bing-hong;PAN Yan-ting(Department of Neurology,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院神经内三科,河北张家口075000

出　　处：《临床误诊误治》2020年第7期49-53,共5页Clinical Misdiagnosis & Mistherapy

摘　　要：目的观察阿替普酶联合丁苯酞治疗急性脑梗死的临床效果及对机体血清炎性因子和血流动力学指标的影响。方法选取我院2017年10月-2019年1月收治的急性脑梗死114例,根据治疗方法的不同分为观察组(n=59)和对照组(n=55)。对照组予阿替普酶静脉溶栓联合常规治疗,观察组在对照组治疗基础上联合丁苯酞治疗。两组疗程均为14 d。比较两组临床疗效,采用美国国立卫生研究院卒中量表(NIH stroke scale, NIHSS)评分评价治疗前后神经功能,利用Barthel指数(BI)评估治疗前后生活质量,检测治疗前后血清炎性因子[白细胞介素-6(IL-6)、白细胞介素-8(IL-8)及C反应蛋白(CRP)]及血流动力学指标(全血高切黏度、全血低切黏度和血浆黏度)变化,观察不良反应发生情况。结果观察组治疗总有效率为89.83%高于对照组的76.36%,差异有统计学意义(χ2=2.374,P=0.030)。与对照组治疗后比较,观察组治疗后NIHSS评分、全血高切黏度、全血低切黏度及血浆黏度均下降,BI升高,IL-6、IL-8及CRP水平降低,差异有统计学意义(P<0.05);与本组治疗前比较,两组治疗后NIHSS评分、全血高切黏度、全血低切黏度及血浆黏度显著下降,BI明显升高,IL-6、IL-8及CRP水平显著降低,差异均有统计学意义(P<0.05)。两组治疗期间不良反应总发生率比较差异无统计学意义(χ2=0.824,P=0.283)。结论阿替普酶联合丁苯酞治疗急性脑梗死可显著提高临床疗效,促进神经功能恢复,改善生活质量和血流动力学状态,降低机体炎性反应,且治疗安全性良好。Objective To observe the clinical effect of alteplase combined with butylphthalide on acute cerebral infarction(ACI) and its influence on serum inflammatory factors and hemodynamic parameters. Methods A total of 114 patients with ACI admitted to our hospital from October 2017 to January 2019 were divided into observation group(n=59) and control group(n=55) according to different treatment methods. The control group was treated with intravenous thrombolysis with ateplase on the basis of conventional treatment, while the observation group was treated with butylphthalide on the basis of the control group. The course of treatment was 14 days. The clinical efficacy of the two groups was compared at 14 days after treatment. The neurological function before and after treatment was evaluated by NIH stroke scale(NIHSS), and quality of life before and after treatment was assessed by Barthel index(BI). The serum inflammatory factors [interleukin-6(IL-6), interleukin-8(IL-8) and C-reactive protein(CRP)] and changes in hemodynamics(whole blood high shear viscosity, whole blood low shear viscosity and plasma viscosity) of the two groups before and after treatment were compared. The occurrence of adverse reactions during the treatment of the two groups was observed. Results After treatment, the total effective rate of the observation group was 89.83%, which was higher than 76.36% of the control group(χ2=2.374, P=0.030). As compared with those in the control group after treatment, the NIHSS scores of the two groups decreased significantly and the BI increased significantly, and the NIHSS scores, whole blood high shear viscosity, whole blood low shear viscosity and plasma viscosity of the observation group were decreased, BI was increased, and the levels of IL-6, IL-8 and CRP were decreased(P<0.05). As compared with those in the same group before treatment, NIHSS scores, the whole blood high shear viscosity, whole blood low shear viscosity and plasma viscosity of the two groups were decreased significantly, BI was increased, and

关 键 词：脑梗死 急性 阿替普酶 丁苯酞 白细胞介素6 C反应蛋白 

分 类 号：R743.33[医药卫生—神经病学与精神病学]