rt-PA静脉溶栓治疗伴有HMCAS急性脑梗死患者的临床效果及对血清t-PA、PAI-1水平和免疫功能的影响  

Clinical effect of rt-PA intravenous thrombolysis on patients with acute cerebral infarction accompanied by HMCAS and its influences on serum t-PA,PAI-1 levels and immune function

作　　者：梁浩 LIANG Hao(No.1 Ward of Neurology Department,the People's Hospital of Luyi,Zhoukou 477299,China)

机构地区：[1]鹿邑县人民医院神经内科一病区,河南周口477299

出　　处：《临床医学研究与实践》2024年第12期52-55,共4页Clinical Research and Practice

摘　　要：目的探讨重组组织型纤溶酶原激活物(rt-PA)治疗伴有大脑中动脉高密度征(HMCAS)急性脑梗死患者的临床效果及对血清组织型纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制物1(PAI-1)水平和免疫功能的影响。方法选取2020年3月至2022年6月在我院治疗的132例伴有HMCAS急性脑梗死患者的临床资料进行研究,根据治疗方案将其分为对照组(n=66)和观察组(n=66)。对照组给予常规治疗,观察组在此基础上给予rt-PA静脉溶栓治疗。比较两组的治疗效果。结果治疗7 d后,两组的美国国立卫生研究院卒中量表(NIHSS)评分均降低,且观察组显著低于对照组(P<0.05)。治疗7 d后,观察组的t-PA水平显著高于对照组,PAI-1水平显著低于对照组(P<0.05)。治疗7 d后,两组的CD3^(+)、CD4^(+)、免疫球蛋白G(IgG)和免疫球蛋白M(IgM)水平高于治疗前,且观察组显著高于对照组(P<0.05)。观察组的Barthel指数评分、改良Rankin量表(mRS)评分0~2分占比明显高于对照组(P<0.05)。结论rt-PA静脉溶栓治疗伴有HMCAS急性脑梗死效果较好,可有效改善患者t-PA、PAI-1水平,提升免疫功能,且安全性较高。Objective To investigate the clinical effect of recombinant tissue-type plasminogen activator(rt-PA)intravenous thrombolysis on patients with acute cerebral infarction accompanied by hyperdense middle cerebral artery sign(HMCAS)and its influences on serum tissue-type plasminogen activator(t-PA),plasminogen activitor inhibitor-1(PAI-1)levels and immune function.Methods The clinical data of 132 patients with acute cerebral infarction accompanied by HMCAS treated in our hospital from March 2020 to June 2022 were selected for study.According to the treatment plan,the patients were divided into control group(n=66)and observation group(n=66).The control group was given conventional treatment,and the observation group was treated with rt-PA intravenous thrombolysis on this basis.The therapeutic effects of the two groups were compared.Results After 7 d of treatment,the National Institute of Health Stroke Scale(NIHSS)score of both groups decreased,and that in the observation group was significantly lower than the control group(P<0.05).After 7 d of treatment,the t-PA level in the observation group was significantly higher than that in the control group,and the PAI-1 level was significantly lower than that in the control group(P<0.05).After 7 d of treatment,the CD3^(+),CD4^(+),immunoglobulin G(IgG)and immunoglobulin M(IgM)levels in both groups were higher than those before treatment,and those in the observation group were significantly higher than the control group(P<0.05).The Barthel index score and proportion of Modified Rankin Scale(mRS)score from 0 to 2 in the observation group were significantly higher than those in the control group(P<0.05).Conclusion rt-PA intravenous thrombolysis in the treatment of acute cerebral infarction accompanied by HMCAS has a good effect,which can effectively improve the levels of t-PA and PAI-1,and enhance immune function,with high safety.

关 键 词：重组组织型纤溶酶原激活物 大脑中动脉高密度征 急性脑梗死 免疫功能 静脉溶栓 

分 类 号：R743.3[医药卫生—神经病学与精神病学]