丁苯酞联合阿替普酶治疗对急性缺血性脑卒中患者神经功能凝血功能血清TNF-α hs-CRP Hcy水平的影响  

Effect of Butyphthal Combined with Alteplase on Neurological Function and Coagulation Function and Serological Indexes as TNF-α hs-CRP and Hcy in Patients with Acute Ischemic Stroke

作　　者：刘海超[1] 闫建炜 温宏峰[1] 王培福[1] LIU Haichao;YAN Jianwei;EN Hongfeng(Space Center Hospital, Beijing 100049 , China)

机构地区：[1]航天中心医院,北京100049

出　　处：《河北医学》2021年第1期150-156,共7页Hebei Medicine

基　　金：北京市科技计划课题,(编号:Z171100001017137)。

摘　　要：目的:探讨丁苯酞联合阿替普酶治疗对急性缺血性脑卒中患者疗效和安全性及对卒中患者神经功能、凝血功能、超敏c反应蛋白(hs-CRP)、血清肿瘤坏死因子-α(TNF-α)、同型半胱氨酸(Hcy)水平的影响。方法:收集134例急性缺血性脑卒中患者,随机数字表法分为两组,对照组67例,采用基础治疗+阿替普酶,联合组采用基础治疗+阿替普酶+丁苯酞,治疗2周后,对比两组临床疗效,评估、检测并比较两组美国国立卫生研究院卒中量表(NIHSS)评分、脑梗死体积、血神经元特异烯醇化酶(NSE)、S100β蛋白(S100β)、纤维蛋白原(FIB)、D-二聚体(D-D)、凝血酶原时间(PT)、部分活化凝血酶活化时间(APTT)、TNF-α、hs-CRP、Hcy。结果:联合组治疗效果优于对照组,差异有统计学意义(P<0.05)。两组治疗后NIHSS评分、脑梗死体积、NSE、S100β均与本组治疗前相比降低,且联合组治疗后低于对照组治疗后,差异均有统计学意义(P<0.05);治疗后两组FIB、D-D均与本组治疗前比较降低,APTT、PT升高;且联合组治疗后FIB、D-D均低于对照组治疗后,APTT、PT均高于对照组治疗后,差异均有统计学意义(P<0.05)。两组治疗后TNF-α、hs-CRP、Hcy均与本组治疗前比较降低,且联合组治疗后TNF-α、hs-CRP、Hcy均低于对照组治疗后,差异均有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:与单纯阿替普酶治疗相比,联合丁苯酞可以提高急性缺血性脑卒中患者治疗效果,促进神经功能恢复,改善凝血功能,降低炎症反应,且安全性良好。Objective:To observe the clinical effect and safety of Ateplase combined with Agatroban on acute ischemic stroke(AIS)and its influence on neurological function and coagulation function and serological indexes such as high sensitive C reaction protein(hs-CRP)、tumornecrosis factor-α(TNF-α)and homocysteine(Hcy).Methods:A total of 134 patients with AIS were selected and divided into two groups by random number table method.The control group consisted of 67 patients who received basic treatment+alteplase and the combination group received basic treatment+alteplase+butylphthal.Both groups were treated for 2 weeks,and the clinical efficacy was compared.National Institutes of Health Stroke Scale(NIHSS),cerebral infarction volume,neuron-specific enolase(NSE),S100βprotein,fibrinogen(FIB),D-dimer(D-D),prothrombin time(PT),activated partial thromboplastin time(APTT),TNF-α,hs-CRP and Hcy was evaluated,detected,and compared.Results:The efficacy of the combination group was better than control group,respectively,with significant difference(P<0.05).Comparison before treatment revealed that the NIHSS score,cerebral infarction volume,NSE,S100β,FIB and D-D in the two groups were lower,and APTT and PT were increased after treatment.Compared with the control group,and NIHSS score,cerebral infarction volume,NSE,S100β,FIB and D-D in combination group was lower,while APTT and PT were increased after treatment,suggesting significant difference(P<0.05).After treatment,the TNF-α,hs-CRP,and Hcy in both groups were lower than those before treatment,and the TNF-α,hs-CRP,and Hcy in the combination group were lower than the control group,with statistical significance(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Butylphthal combined with alteplase can improve the treatment effect,promote nerve function recovery,improve coagulation function,reduce the inflammatory reaction,and has good safety of patients with AIS,compared to the alteplase alone treatment.

关 键 词：丁苯酞 阿替普酶 急性缺血性脑卒中 神经功能 凝血功能 炎症 

分 类 号：R743.3[医药卫生—神经病学与精神病学]