rt-PA静脉溶栓联合丁苯酞治疗超早期脑梗死患者的临床疗效  

Clinical effects of rt-PA intravenous thrombolysis combined with butylphthalide in patients with ultra-early acute ischemic stroke

作　　者：范贵娜 万东升 孙丽萍 Fan Guina;Wan Dongsheng;Sun Liping(Pingdingshan Second People's Hospital,Pingdingshan 467000,Henan,China)

机构地区：[1]平顶山市第二人民医院,河南平顶山467000

出　　处：《临床心身疾病杂志》2023年第2期32-35,54,共5页Journal of Clinical Psychosomatic Diseases

摘　　要：目的探讨重组组织型纤溶酶原激活物静脉溶栓联合丁苯酞治疗超早期脑梗死患者的临床疗效。方法将120例超早期脑梗死患者按照治疗方法分为研究组65例与对照组55例。两组均给予重组组织型纤溶酶原激活物静脉溶栓治疗,研究组在此基础上联合丁苯酞治疗,观察2周。结果治疗后两组美国国立卫生研究院卒中量表评分均较治疗前显著降低(P<0.01),Brathel指数评分均较治疗前显著升高(P<0.01),研究组较对照组变化更显著(P<0.01)。治疗后两组患者梗死灶体积均较治疗前显著缩小(P<0.01),研究组显著小于对照组(P<0.01)。治疗后两组血清超氧化歧化酶水平较治疗前显著升高(P<0.01),肝细胞生长因子、丙二醛水平较治疗前显著降低(P<0.01),研究组较对照组变化更显著(P<0.01)。治疗后两组健康调查简表各维度评分均较治疗前显著升高(P<0.01),研究组显著高于对照组(P<0.01)。研究组不良反应发生率显著低于对照组(P<0.05)。结论重组组织型纤溶酶原激活物静脉溶栓联合丁苯酞治疗超早期脑梗死患者效果显著,可改善患者神经功能及日常活动能力,缩小梗死灶体积,缓解氧化损伤,促进机体修复,提高生活质量,且安全性高。Objective To explore the clinical effects of the intravenous thrombolysis of recombinant tissue-type plasmin activator(rt-PA)combined with butylphthalide in patients with ultra-early acute ischemic stroke(AIS).Methods According to treatment methods 120 AIS patients were assigned to research(n=65)and control(n=55)group.Patients of both groups received rt-PA,on this basis research group was plus butylphthalide,and observed for 2 weeks.Results Scores of both groups on the National Institutes of Health Stroke Scale(NIHSS)lowered more significantly(P<0.01),those on Barthel Index elevated(P<0.01),and changes were more significant in research than in control group(P<0.01)after treatment compared with pre-treatment.Infarct volumes of both groups lessened more significantly and so did in research than in control group(P<0.01).Of both groups serum SOD levels heightened more significantly(P<0.01),hepatocyte growth factor and malondialdehyde lowered more significantly(P<0.01),and changes were more significant in research than in control group(P<0.01)after treatment.After treatment the scores of all dimensions of the MOS 36-item Short Form Health Survey(SF-36)heightened more significantly in both groups(P<0.01)and so did in research than in control group(P<0.01).Incidences of adverse reactions were significantly lower in research than in control group(P<0.05).Conclusion The combination of rt-PA intravenous thrombolysis butylphthalide has significant effects,can improve nerve functions and activities of daily living,decrease infarction focus volume,relieve oxidative damage,promote organic repair,improve quality of life,and have higher safety.

关 键 词：脑梗死 超早期 静脉溶栓 丁苯酞 神经功能 生活质量 

分 类 号：R743.3[医药卫生—神经病学与精神病学]