早期阿替普酶溶栓对急性脑梗死患者hs-CRP、Lp-PLA2及神经功能的影响  

Impacts of early rt-pa thrombolysis on hs-CRP and Lp-PLA2 and neurological function in patients with acute cerebral infarction

作　　者：陈丽芳[1] 徐佳宁[1] CHEN Lifang;XU Jia'ning(Emergency Department,Jiangyin People's Hospital,Jiangsu,Jiangyin 214400,China)

机构地区：[1]江苏省江阴市人民医院急诊科,江苏江阴214400

出　　处：《中国医药科学》2020年第19期236-238,242,共4页China Medicine And Pharmacy

摘　　要：目的观察早期阿替普酶(rt-pa)溶栓治疗对急性脑梗死患者高敏C反应蛋白(hs-CRP)、脂蛋白磷脂酶A2(Lp-PLA2)以及神经功能的影响。方法回顾性分析2018年1月~2020年2月于我院急诊就诊的91例急性脑梗死患者,按照溶栓时间的不同分为早期溶栓组和晚期溶栓组。早期溶栓组49例,在常规对症治疗的基础上于入院3h内即应用rt-pa静脉溶栓治疗,而晚期溶栓组42例,在常规对症治疗的基础上于入院3~5h应用rt-pa静脉溶栓治疗,比较两组患者治疗前后hs-CRP、Lp-PLA2以及神经功能相关指标(NIHSS、NSE、GFAP)水平。结果治疗前,两组患者hs-CRP、Lp-PLA2以及NIHSS、NSE、GFAP比较,差异无统计学意义(P>0.05);治疗后,两组患者的hs-CRP、Lp-PLA2、NIHSS、NSE、GFAP水平均显著降低,与同组治疗前比较,差异有统计学意义(P<0.05);早期溶栓组患者的hs-CRP、Lp-PLA2、NIHSS、NSE、GFAP水平明显低于晚期溶栓组,差异有统计学意义(P<0.05)。结论对急性脑梗死患者在入院3h内应用rt-pa静脉溶栓治疗,不仅可以显著降低患者hs-CRP、Lp-PLA2水平,而且可以明显降低患者神经功能相关指标,提高疗效,值得临床上研究应用。Objective To observe the efficacy of early rt-pa(alteplase)thrombolytic therapy on hs-CRP,Lp-PLA2 and neurological function in patients with acute cerebral infarction.Methods A retrospective analysis was made on 91 patients with acute cerebral infarction admitted to the emergency department of our hospital from January 2018 to February 2020.They were divided into the early thrombolysis group and the late thrombolysis group according to different thrombolysis time.49 patients in the early thrombolysis group were treated with rt-pa intravenous thrombolysis within 3 hours of admission on the basis of routine symptomatic treatment,while 42 patients in the late thrombolysis group were treated with rt-pa intravenous thrombolysis within 3-5 hours of admission on the basis of routine symptomatic treatment.The levels of hs-CRP,Lp-PLA2 and neurological function related indexes(NIHSS,NSE,GFAP)at baseline and after treatment were compared between the two groups.Results At baseline,there were no significant differences between the two groups in hs-CRP,Lp-PLA2 and NIHSS,NSE,GFAP(P>0.05).After treatment,the levels of hs-CRP,Lp-PLA2,NIHSS,NSE and GFAP in the two groups of patients were significantly reduced,and the differences were statistically significant(P<0.05)compared with that in the same group at baseline.Moreover,the levels of hs-CRP,Lp-PLA2,NIHSS,NSE and GFAP in the early thrombolysis group were significantly lower than those in the late thrombolysis group,and the differences between the two groups were statistically significant(P<0.05).Conclusion Intravenous thrombolytic therapy with rt-pa within 3 hours of admission for patients with acute cerebral infarction not only significantly reduces the levels of patients'hs-CRP and Lp-PLA2,but also significantly decreases the neurological function related indexes of patients and improves the efficacy,which is worthy of clinical research and application.

关 键 词：急性脑梗死 阿替普酶 早期溶栓 高敏C反应蛋白 脂蛋白磷脂酶A2 神经功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]