对比尿激酶与阿替普酶静脉溶栓在急性前循环脑梗死患者中的应用效果  

Comparison of the Effects of Intravenous Thrombolysis with Urokinase and Ateplase in Patients with Acute Anterior Circulation Cerebral Infarction

作　　者：那慧 NA Hui(Department of Neurology,Hulunbuir People's Hospital,Hulunbuir 021000,China)

机构地区：[1]呼伦贝尔市人民医院神经内科,内蒙古呼伦贝尔021000

出　　处：《反射疗法与康复医学》2024年第10期120-123,共4页Reflexology And Rehabilitation Medicine

摘　　要：目的探讨尿激酶与阿替普酶(rt-PA)静脉溶栓治疗急性前循环脑梗死的临床效果。方法选取2022年6月—2023年9月呼伦贝尔市人民医院收治的64例急性前循环脑梗死患者为研究对象,按随机数字表法将其分为对照组和观察组,各32例。对照组行尿激酶静脉溶栓,观察组行rt-PA静脉溶栓。治疗14 d后比较两组的临床疗效、神经功能、预后情况、大脑中动脉血流参数、炎症水平及不良反应发生情况。结果观察组治疗总有效率较对照组高,差异有统计学意义(P<0.05)。治疗后,观察组神经功能缺损评分、改良Rankin量表评分别为(8.96±1.13)分、(1.66±0.23)分,均低于对照组的(10.47±1.25)分、(2.04±0.25)分,组间差异有统计学意义(P<0.05);观察组大脑中动脉平均血流速度、舒张末期流速、流速峰值分别为(75.41±5.83)cm/s、(49.58±4.45)cm/s、(95.68±6.78)cm/s,均高于对照组的(67.89±5.74)cm/s、(42.36±4.28)cm/s、(88.41±6.59)cm/s,组间差异有统计学意义(P<0.05);观察组超敏C反应蛋白、白细胞介素-1β、肿瘤坏死因子-α水平均低于对照组,组间差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论rt-PA静脉溶栓治疗急性前循环脑梗死的效果更佳,可减轻患者的神经功能障碍,改善预后情况,安全可行。Objective To investigate the clinical effect of intravenous thrombolytic therapy of urokinase and Alteplase(rt-PA)on acute anterior circulation cerebral infarction.Methods A total of 64 patients with acute anterior circulation cerebral infarction admitted to Hulunbuir People's Hospital from June 2022 to September 2023 were selected as the research subjects,and divided into a control group and an observation group according to random number table method,with 32 cases in each group.The control group received intravenous thrombolytic therapy with urokinase,and the observation group received intravenous thrombolytic therapy with rt-PA.After 14 days of treatment,the clinical efficacy,neurological function,prognosis,middle cerebral artery blood flow parameters,inflammation level and adverse reactions of the two groups were compared.Results The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the neurological deficit score and modified Rankin scale score of the observation group were(8.96±1.13)points and(1.66±0.23)points,which were lower than(10.47±1.25)points and(2.04±0.25)points of the control group,and the differences between the groups were statistically significant(P<0.05);the average blood flow velocity,end diastolic flow velocity,and peak flow velocity of the middle cerebral artery in the observation group were(75.41±5.83)cm/s,(49.58±4.45)cm/s,and(95.68±6.78)cm/s,respectively,which were higher than(67.89±5.74)cm/s,(42.36±4.28)cm/s,and(88.41±6.59)cm/s in the control group,and the differences between the groups were statistically significant(P<0.05);the levels of high-sensitivity C-reactive protein,interleukin-1β,and tumor necrosis factor-αin the observation group were lower than those in the control group,and the differences between the groups were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P

关 键 词：急性前循环脑梗死 尿激酶 阿替普酶 静脉溶栓 神经功能 

分 类 号：R743[医药卫生—神经病学与精神病学]