阿替普酶静脉溶栓治疗对缺血性脑卒中患者炎症因子水平影响研究  

The effect of intravenous thrombolytic therapy with alteplase on inflammatory cytokines in patients with ischemic stroke

作　　者：鲁庆波[1] 王静静 于慧娟 严伟[1] LU Qing-bo;WANG Jing-jing;YU Hui-juan;YAN Wei(Second Department of Internal Neurology,First People's Hospital of Kashgar,Kashgar 844000,China)

机构地区：[1]新疆喀什地区第一人民医院神经内二科,新疆喀什844000

出　　处：《临床军医杂志》2021年第6期645-647,650,共4页Clinical Journal of Medical Officers

基　　金：新疆维吾尔自治区天山青年计划项目(2017Q149)。

摘　　要：目的探讨阿替普酶静脉溶栓治疗对缺血性脑卒中患者炎症因子水平的影响。方法选取2019年1—10月新疆喀什地区第一人民医院收治的80例缺血性脑卒中患者为研究对象。采用随机数字表法将患者分为A组与B组,每组各40例。A组接受重组组织型纤溶酶原激活剂(rt-PA)治疗;B组在A组的基础上接受阿替普酶静脉溶栓治疗。观察并比较两组患者治疗前后的血清炎症因子水平、炎症应激反应指标、凝血功能指标。结果B组治疗后白细胞介素1β(IL-1β)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)水平明显低于A组,差异有统计学意义(P<0.05)。B组治疗后丙二醛(MDA)水平低于A组,超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(CSH-px)水平高于A组,差异有统计学意义(P<0.05)。B组治疗后凝血活酶时间(APTT)、凝血酶时间(TT)、凝血因子Ⅷ(FⅧ)低于A组,凝血酶原时间(PT)、血友病因子(VWF)高于A组,差异有统计学意义(P<0.05)。结论采用阿替普酶静脉溶栓治疗缺血性脑卒中患者,可以改善患者的炎症反应,调节凝血功能,降低炎症指标水平,具有一定的临床应用价值。Objective To investigate the effects of inflammatory factors and prognosis of intravenous thrombolytic therapy with alteplase in patients with ischemic stroke.Methods A total of 80 patients with ischemic stroke admitted to our hospital from January to October 2019 were selected as the research subjects.The patients were divided into group A and group B by random number table method,with 40 cases in each group.Group A received recombinant tissue-type plasminogen activator(rt-PA);Group B received intravenous thrombolytic therapy with alteplase on the basis of group A.Observe and compare the differences in serum levels of inflammatory factors,inflammatory stress response,coagulation function between the two groups.Results After treatment,the levels of interleukin 1β(IL-1β),hypersensitive C-reactive protein(hs-CRP)and tumor necrosis factorα(TNF-α)in group B were significantly lower than those in group A,with statistical significance(P<0.05).After treatment,the levels of malondialdehyde(MDA)in group B were lower than those in group A,while the levels of superoxide dismutase(SOD)and glutathione peroxidase(CSH-Px)in group B were higher than those in group A,with statistical significance(P<0.05).After treatment,the activated partial thromboplastin time(APTT),thrombin time(TT)and coagulation factorⅧ(FⅧ)in group B were lower than those in group A,while the prothrombin time(PT)and hemophilia factor(VWF)in group B were higher than those in group A,with statistical significance(P<0.05).Conclusion Using alteplase intravenously to treat patients with ischemic stroke can improve the patient's inflammatory response,regulate blood coagulation function,and reduce the level of inflammatory indicators.

关 键 词：缺血性脑卒中 静脉溶栓 阿替普酶 炎症因子 

分 类 号：R743.34[医药卫生—神经病学与精神病学]