阿替普酶联合早期肠内营养制剂用于急性脑梗死患者的效果观察  

Efficacy of Alteplase Combined with Early Enteral Nutrition Preparation in the Treatment of Acute Cerebral Infarction

作　　者：王晶晶 葛春霞[1] 孙青[1] 姜新娣[2] 陈小进 WANG Jingjing;GE Chunxia;SUN Qing;JIANG Xindi;CHEN Xiaojin(Dept.of Neurology,Hai’an People’s Hospital Affiliated to Nantong University,Jiangsu Hai’an 226600,China;Dept.of Neurology,Affiliated Hospital of Nantong University,Jiangsu Nantong 226006,China)

机构地区：[1]南通大学附属海安市人民医院神经内科,江苏海安226600 [2]南通大学附属医院神经内科,江苏南通226006

出　　处：《中国医院用药评价与分析》2024年第6期697-700,704,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：江苏省卫健委科研课题(No.Z2019042)。

摘　　要：目的:探讨阿替普酶联合早期肠内营养制剂用于急性脑梗死患者的作用效果。方法:选取2021年1月至2023年6月南通大学附属海安市人民医院收治的急性脑梗死患者98例,采用随机数字表法分为观察组和对照组,各49例。对照组患者在阿替普酶溶栓后给予早期常规自制鼻饲流质饮食治疗,观察组患者在阿替普酶溶栓后给予早期鼻饲肠内营养制剂治疗。比较两组患者的临床疗效、营养状况[前白蛋白(PA)、白蛋白(ALB)和总蛋白(TP)]、神经功能[美国国立卫生院卒中神经功能缺损评分量表(NIHSS)评分]、神经损伤标志细胞因子[血清神经元特异性烯醇化酶(NSE)、S100钙结合蛋白β(S100β)和脑源性神经营养因子(BDNF)]水平、格拉斯哥结局评分(GOS)、颅内出血率和住院指标。结果:治疗后,观察组患者的总有效率显著高于对照组[83.7%(41/49)vs. 65.3%(32/49)],差异有统计学意义(χ^(2)=4.353,P<0.05)。治疗后,观察组患者的PA水平(t=12.593,P<0.001)、ALB水平(t=4.583,P<0.001)、TP水平(t=4.497,P<0.001)、BDNF水平(t=4.619,P<0.01)和GOS评分(t=4.342,P<0.001)高于对照组,NIHSS评分(t=5.371,P<0.001)、NSE水平(t=4.342,P<0.001)和S100β水平(t=6.015,P<0.001)低于对照组,加强监护病房停留时间(t=4.358,P<0.001)、住院时间(t=6.509,P<0.001)短于对照组,上述差异均有统计学意义。对照组1例患者出现无症状性脑出血,观察组无患者出现无症状性脑出血,两组患者均未出现症状性颅内出血;两组患者颅内出血率的差异无统计学意义(P>0.05)。结论:阿替普酶联合早期肠内营养制剂对于减轻急性脑梗死患者神经损伤的疗效良好,还有助于促进患者营养状况和预后质量的改善,具有较好的临床应用价值。OBJECTIVE:To probe into the clinical effect of alteplase combined with early enteral nutrition preparation on patients with acute cerebral infarction.METHODS:A total of 98 patients with acute cerebral infarction admitted into Hai’an People’s Hospital Affiliated to Nantong University from Jan.2021 to Jun.2023 were selected to be divided into observation group and control group via random number table method,with 49 cases in each group.The control group was given early routine self-made nasal feeding liquid diet after alteplase thrombolytic therapy,while the observation group received early nasal feeding enteral nutrition preparation after alteplase thrombolytic therapy.The clinical efficacy,nutritional status indicators[prealbumin(PA),albumin(ALB)and total protein(TP)],neurological function[National Institutes of Health Stroke Scale(NIHSS)],neuro-impairment markers levels[serum neuron-specific enolase(NSE),S100 calcium binding proteinβ(S100β)and brain-derived neurotrophic factor(BDNF)],Glasgow outcome scores(GOS),intracranial hemorrhage rate and hospitalization indicators were compared between two groups.RESULTS:After treatment,the total effective rate of the observation group was significantly higher than that of control group[83.7%(41/49)vs.65.3%(32/49)],with statistically significant difference(χ^(2)=4.353,P<0.05).After treatment,the PA level(t=12.593,P<0.001),ALB level(t=4.583,P<0.001),TP level(t=4.497,P<0.001),BDNF level(t=4.619,P<0.01)and GOS score(t=4.342,P<0.001)of the observation group were higher than those of the control group,the NIHSS score(t=5.371,P<0.001),NSE level(t=4.342,P<0.001)and S100β(t=6.015,P<0.001)of the observation group were lower than those of the control group,the ICU stay(t=4.358,P<0.001)and hospital stay(t=6.509,P<0.001)of the observation group were shorter than those of control group,all of the above differences were statistically significant.One patient in the control group developed asymptomatic cerebral hemorrhage,while no patient in the observation group developed asympto

关 键 词：阿替普酶 营养制剂 急性脑梗死 肠内营养 临床疗效 

分 类 号：R972[医药卫生—药品] R977[医药卫生—药学]