一种重组组织纤溶酶原激活剂-阿替普酶静脉溶栓对急性脑梗死的治疗效果分析  

Effect analysis of intravenous thrombolytic therapy of Alteplase,a recombinant tissue plasminogen activator,on acute cerebral infarction

作　　者：董存涛 Dong Cun-tao(Department of Brain,Luoyang Yiluo Hospital,Luoyang 471000,Henan,China)

机构地区：[1]洛阳伊洛医院脑科,河南洛阳471000

出　　处：《四川生理科学杂志》2024年第11期2516-2518,共3页

摘　　要：目的:探究阿替普酶(Recombinant tissue plasminogen activator,rt-PA)静脉溶栓对急性脑梗死(Acute cerebral infarction,ACI)患者神经功能及脑出血发生情况的影响。方法:选取2019年9月至2022年9月医院收治的62例ACI患者作为研究对象,根据溶栓方案不同分为对照组和观察组,各31例。对照组采用静脉滴注注射用尿激酶溶栓,观察组采用静脉给药注射用重组组织纤溶酶原激活剂-阿替普酶溶栓。分析比较两组治疗前、治疗后2 w时的神经功能[美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分];神经损伤标志物水平[神经元特异性烯醇化酶(Neuron specific enolase,NSE)、中枢性神经特异性蛋白(Central nervous system specific proteinβ,S100β)];溶栓后24 h血管再通情况;溶栓后48 h内脑出血发生情况。结果:治疗2 w时,两组NIHSS评分均较治疗前明显降低,且观察组NIHSS评分明显低于对照组(P<0.05);两组血清NSE、S100β水平均较治疗前明显降低,且观察组血清NSE、S100β均明显低于对照组(P<0.05)。溶栓后24 h观察组血管再通率明显高于对照组(P<0.05)。溶栓后48 h内观察组脑出血发生率明显低于对照组(P<0.05)。结论:rt-PA静脉溶栓治疗ACI可改善患者神经功能及神经损伤标志物水平,促使血管再通,减少脑出血的发生。Objective:To investigate the effects of Alteplase(Recombinant tissue plasminogen activator,rt-PA)intravenous thrombolysis on neurological function and cerebral hemorrhage in patients with acute cerebral infarction(ACI).Methods:A total of 62 ACI patients admitted to the hospital from September 2019 to September 2022 were selected as the research subjects.They were divided into a control group and an observation group based on different thrombolysis regimens,with 31 cases in each group.The control group received intravenous infusion of urokinase for thrombolysis,while the observation group received intravenous injection of recombinant tissue plasminogen activator ateplase for thrombolysis.The neurological function[National Institute of Health stroke scale(NIHSS)score]of the two groups before treatment and 2 weeks after treatment,the levels of nerve injury markers[Neuron specific enolase(NSE),Central nervous system specific proteinβ(S100β)],vascular recanalization 24 hours after thrombolysis and the occurrence of cerebral hemorrhage within 48 hours after thrombolysis were analyzed and compared.Results:At 2 weeks of treatment,both groups showed a significant decrease in NIHSS scores compared to before treatment,and the observation group had significantly lower NIHSS scores than the control group(P<0.05).The levels of serum NSE and S100βin the two groups were significantly lower than those before treatment,and the levels of serum NSE and S100βin the observation group were significantly lower than those in the control group(P<0.05).The vascular revascularization rate in the observation group was significantly higher than that in the control group at 24h after thrombolysis(P<0.05).The incidence of cerebral hemorrhage in the observation group was significantly lower than that in the control group within 48h after thrombolysis(P<0.05).Conclusion:Intravenous thrombolysis with rt-PA in the treatment of ACI can improve the neurological function and the level of nerve injury markers,promote vascular recanalization,and red

关 键 词：急性脑梗死 阿替普酶 尿激酶 重组组织纤溶酶原激活剂 神经功能 

分 类 号：R743.33[医药卫生—神经病学与精神病学]