尤瑞克林联合阿替普酶治疗急性脑梗死的疗效  

Effect of urinary kallidinogenase combined with alteplase on acute cerebral infarction

作　　者：洪春阳[1] 王丹[1] 王慧[1] 鲁柏涛[1] HONG Chunyang;WANG Dan;WANG Hui;LU Baitao(The First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院,黑龙江哈尔滨150001

出　　处：《中国实用神经疾病杂志》2024年第9期1152-1156,共5页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨尤瑞克林联合阿替普酶(rt-PA)治疗急性脑梗死(ACI)的效果。方法选取2020-05—2023-02哈尔滨医科大学附属第一医院收治的94例ACI患者,随机数字表法分为rt-PA组和联合组各47例。于ACI常规治疗基础上,rt-PA组给予rt-PA治疗,联合组给予尤瑞克林联合rt-PA治疗,均治疗14 d,比较2组患者治疗效果、脑血流速度和血清内皮素-1(ET-1)、血栓素A2(TXA2)水平。结果2组患者治疗后NIHSS评分均较治疗前明显下降(P<0.05),且联合组治疗后NIHSS评分[(7.15±2.14)分比(8.64±2.37)分]低于rt-PA组,NIHSS减分率[(55.86±10.16)%比(46.44±11.23)%]、总有效率(91.49%比74.47%)均高于rt-PA组(P<0.05)。2组患者治疗后大脑中动脉(MCA)、大脑前动脉(ACA)、大脑后动脉(PCA)、椎动脉(VA)和基底动脉(BA)血流速度均较治疗前提高(P<0.05),血清ET-1、TXA2水平较治疗前下降(P<0.05),且联合组治疗后MCA[(48.67±8.13)cm/s比(45.18±8.07)cm/s]、ACA[(44.86±7.12)cm/s比(41.78±6.95)cm/s]、PCA[(41.28±5.94)cm/s比(37.96±5.80)cm/s]、VA[(32.47±6.28)cm/s比(29.31±6.32)cm/s]、BA[(35.90±6.27)cm/s比(32.85±6.03)cm/s]血流速度高于rt-PA组,血清ET-1[(52.62±6.50)ng/L比(62.41±7.23)ng/L]、TXA2[(53.30±8.49)ng/L比(68.29±10.13)ng/L]水平低于rt-PA组(P<0.05)。结论尤瑞克林联合rt-PA静滴治疗ACI效果显著,能有效改善脑血流速度和降低血清ET-1、TXA2表达,促进神经功能恢复。Objective To investigate the effect of urinary kallidinogenase combined with alteplase(rt-PA)on acute cerebral infarction(ACI).Methods A total of 94 patients with ACI admitted to the First Affiliated Hospital of Harbin Medical University from May 2020 to February 2023 were divided into rt-PA group and combined group with 47 patients in each group by random number table method.On the basis of the conventional treatment of ACI,the rt-PA group was given intravenous thrombolytic therapy of rt-PA,and the combined group was given urinary kallidinogenase combined with rt-PA intravenous therapy for 14 days.The therapeutic effects of the two groups were compared,as well as the cerebral blood flow velocity and serum endothelin-1(ET-1)and thromboxane A2(TXA2)levels.Results The NIHSS score of the two groups after treatment was significantly lower than that before treatment(P<0.05),and the NIHSS score of the combined group(7.15±2.14 vs 8.64±2.37)after treatment was lower than that of the rt-PA group.The reduction rate of NIHSS((55.86±10.16)%vs(46.44±11.23)%)and total effective rate(91.49%vs 74.47%)of the combined group were higher than those in the rt-PA group(P<0.05).After treatment,the blood flow velocity of middle cerebral artery(MCA),anterior cerebral artery(ACA),posterior cerebral artery(PCA),vertebral artery(VA)and basilar artery(BA)were all increased compared with before treatment(P<0.05),and the serum ET-1 and TXA2 levels decreased compared with those before treatment(P<0.05).After treatment,the blood flow velocity of MCA(48.67±8.13 vs 45.18±8.07),ACA(44.86±7.12 vs 41.78±6.95),PCA(41.28±5.94 vs 37.96±5.80),VA(32.47±6.28 vs 29.31±6.32)and BA(35.90±6.27 vs 32.85±6.03)in the combined group was higher than that in the rt-PA group,and the serum ET-1(52.62±6.50 vs 62.41±7.23)and TXA2(53.30±8.49 vs 68.29±10.13)levels in the combined group were lower than those in the rt-PA group(P<0.05).Conclusion Urinary kallidinogenase combined with rt-PA has a significant effect in the treatment of ACI,which can effectiv

关 键 词：急性脑梗死 阿替普酶 尤瑞克林 内皮素-1 血栓素A2 

分 类 号：R743.33[医药卫生—神经病学与精神病学]