依达拉奉联合阿替普酶对急性缺血性脑卒中的疗效观察  

Therapeutic effects of edaravone combined with alteplase on with acute ischemic cerebral stroke

作　　者：王慧娟[1] 霍会永[1] 刘运平[1] 李军涛[1] 王超慧 赵萍[1] WANG Huijuan;HUO Huiyong;LIU Yunping(Department of Neurology,Handan Central Hospital,Hebei,Handan 056000,China)

机构地区：[1]河北省邯郸市中心医院神经内二科,056000

出　　处：《河北医药》2023年第1期89-91,95,共4页Hebei Medical Journal

摘　　要：目的研究依达拉奉联合阿替普酶治疗急性缺血性脑卒中(AIS)临床疗效。方法选择2017年1月至2020年7月确诊并接受治疗的92例AIS患者,随机分为对照组和联合组,每组46例。对照组采用注射用阿替普酶治疗,联合组在对照组基础上加用依达拉奉治疗,疗程均为2周。观察2组临床疗效及治疗前后神经功能损伤程度[美国国立卫生研究院神经功能缺损量表(NIHSS)]、日常生活能力评分(ADL)、血液流变学指标[全血黏度、红细胞压积、红细胞聚集指数]、脑血流动力学指标[脑血管峰流速(Vmax)、平均流速(Vmean)、搏动指数(PI)]、卒中相关因子[N末端脑钠肽(NT-proBNP)、同型半胱氨酸(Hcy)、降钙素原(PCT)]变化。结果与对照组比较,联合组临床疗效显著升高(P<0.05)。治疗前,2组NIHSS评分、ADL评分、全血黏度、红细胞压积、红细胞聚集指数、Vmax、Vmean、PI、NT-proBNP、Hcy、PCT比较差异无统计学意义(P>0.05);治疗后,2组NIHSS评分、全血黏度、红细胞压积、红细胞聚集指数、PI、NT-proBNP、Hcy、PCT显著低于治疗前,ADL评分、Vmax、Vmean显著高于治疗前(P<0.05);与对照组比较,联合组NIHSS评分、全血黏度、红细胞压积、红细胞聚集指数、PI、NT-proBNP、Hcy、PCT显著降低,ADL评分、Vmax、Vmean显著升高(P<0.05)。结论依达拉奉联合阿替普酶治疗AIS能够促进患者神经功能和日常活动能力恢复,改善血液流变学,提高脑组织血液灌注量,并降低卒中相关因子水平。Objective To investigate the therapeutic effects of edaravone combined with alteplase on with acute ischemic stroke(AIS).Methods A total of 92 patients with AIS who were treated in our hospital from January 2017 to July 2020 were enrolled in the study, who were randomly divided into two groups, with 46 cases in each group.The patients in control group were treated by by intravenous thrombolysis with alteplase, however, those in combination treatment group, on the basis of control group, were treated by edaravone, with a treatment course of 2 weeks for both groups.After treatment, the clinical efficacy, and neurological impairment, daily living ability, indicators of hemorheology(whole blood viscosity, hematocrit and erythrocyte aggregation index) and cerebral blood flow(Vmax, Vmean and PI),related cytokines(NT-proBNP,Hcy and PCT) before treatment and 2 weeks after treatment were observed and compared between the two groups.Results After treatment, the total effective rate in combination treatment group was significantly higher than that in control group(89.13% vs 71.74%,P<0.05).Before treatment, there were no significant differences in NIHSS scores, ADL scores, whole blood viscosity, hematocrit, erythrocyte aggregation index, Vmax, Vmean, PI, NT-proBNP,Hcy and PCT between two groups(P>0.05).After treatment, NIHSS scores, whole blood viscosity, hematocrit, erythrocyte aggregation index, PI, NT-proBNP,Hcy and PCT in both groups were significantly decreased, however, the ADL scores, Vmax and Vmean were significantly increased(P<0.05),moreover, the increase degree and decrease degree in combination treatment group were more significant than those in control group(P<0.05).Conclusion Edaravone combined with alteplase in treatment of AIS can significantly improve the recovery of neurological function and daily living ability of patients, adjust the hemorheology, increase the cerebral blood flow, and reduce the levels of AIS related cytokines.

关 键 词：依达拉奉 阿替普酶 急性缺血性脑卒中 治疗结果 

分 类 号：R742[医药卫生—神经病学与精神病学]