尿激酶静脉溶栓治疗对急性轻型脑卒中患者血清脂蛋白相关磷脂酶A2、可溶性血管细胞黏附分子-1、基质金属蛋白酶-9水平及神经功能的影响  

Effects of intravenous thrombolysis with urokinase on Lp-PLA2,sVCAM-1,MMP-9 levels and neurological function in patients with acute mild stroke

作　　者：余明艳 李芳[1] YU Mingyan;LI Fang(Department of Neurology,the First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000,China)

机构地区：[1]锦州医科大学附属第一医院神经内科,辽宁锦州121000 [2]辽宁省鞍山市长大医院神经内科,辽宁鞍山114000

出　　处：《陕西医学杂志》2021年第1期79-81,85,共4页Shaanxi Medical Journal

摘　　要：目的:探讨尿激酶静脉溶栓治疗对急性轻型脑卒中患者血清脂蛋白相关磷脂酶A 2(Lp-PLA 2)、可溶性血管细胞黏附分子-1(sVCAM-1)、基质金属蛋白酶-9(MMP-9)水平及神经功能的影响。方法:选取96例急性轻型脑卒中患者,根据是否接受溶栓治疗分为溶栓组(53例)、非溶栓组(43例)。溶栓组予以尿激酶静脉滴入+抗血小板治疗,非溶栓组予以抗血小板治疗,两组均治疗7 d。观察两组入院时、治疗24 h、7 d后的神经功能;入院时、治疗7 d后的血清细胞因子水平及研究期间不良反应发生情况。结果:治疗后24 h、7 d后,两组的卒中量表(NHISS)评分为0~2分患者所占比例均较入院时升高,且溶栓组高于非溶栓组(92.50%、88.70%与75.60%、69.00%,P<0.05)。治疗7 d后,两组血清Lp-PLA 2、sVCAM-1、MMP-9水平均较入院时降低,且溶栓组低于非溶栓组(P<0.05)。研究期间,两组不良反应发生率相比无统计学差异(P>0.05)。结论:尿激酶静脉溶栓治疗急性轻型脑卒中,可有效降低患者血清Lp-PLA 2、sVCAM-1、MMP-9水平,控制机体炎症反应,并改善其神经功能,且安全性良好。Objective:To study the effects of intravenous thrombolysis with urokinase on serum Lp-PLA 2,sVCAM-1,MMP-9 levels and neurological function in patients with acute mild stroke.Methods:96 patients with acute mild stroke were divided into thrombolytic group(53 cases)and non-thrombolytic group(43 cases)according to whether they received thrombolytic therapy.Intravenous urokinase plus antiplatelet therapy was given in the thrombolytic group,and antiplatelet therapy was given in the non-thrombolytic group,both groups were treated for 7 days.The neurological function at admission,24 hours and 7 days after treatment,serum cytokine levels at admission and 7 days after treatment,and adverse reactions during the study period were compared.Results:24 hours and 7 days after treatment,the proportion of patients with NHISS score of 0-2 in both groups increased than those at admission,and the thrombolytic group was higher than the non-thrombolytic group(92.50%vs.75.60%,88.70%vs.69.00%,P<0.05).After 7 days of treatment,the levels of serum Lp-PLA 2,sVCAM-1 and MMP-9 in the two groups were lower than those at admission,and the thrombolytic group was lower than the non-thrombolytic group(P<0.05).During the study period,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Intravenous thrombolysis with urokinase can effectively reduce the levels of serum Lp-PLA 2,sVCAM-1 and MMP-9,control the inflammatory reaction,improve their neurological function with good safety.

关 键 词：急性轻型脑卒中 尿激酶 静脉溶栓 脂蛋白相关磷脂酶A 2 可溶性血管细胞黏附分子-1 基质金属蛋白酶-9 神经功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]