重组人组织型纤溶酶原激活物静脉溶栓联合桥接Solitaire支架对急性缺血性脑卒中患者血管再通率及神经功能恢复的影响  

The effect of recombinant human tissue-typeplasminogen activator intravenous thrombolysiscombined with bridging Solitaire stent on vascularrecanalization rate and neurological function recoveryin patients with acute cerebral ischemic stroke

作　　者：漆琼瑶 曾多[2] 朱飞 丁绍纯 易飞[1] QI Qiongyao;ZENG Duo;ZHU Fei;DING Shaochun;YI Fei(Department of Neurology,Pingxiang People's Hospital,Pingxiang,Jiangxi,337000,China;Department of Neurosurgery,Pingxiang People's Hospital,Pingxiang,Jiangxi,337000,China)

机构地区：[1]萍乡市人民医院神经内科,江西萍乡337000 [2]萍乡市人民医院神经外科,江西萍乡337000

出　　处：《当代医学》2024年第22期59-63,共5页Contemporary Medicine

基　　金：江西省卫生健康委科技计划(202140562)。

摘　　要：目的探讨重组人组织型纤溶酶原激活物(tissue-type plasminogenactivator,rt-PA)静脉溶栓联合桥接Solitaire支架对急性缺血性脑卒中(cerebral ischemic stroke,CIS)患者血管再通率及神经功能恢复的影响。方法选取2019年1月至2022年12月萍乡市人民医院收治的60例CIS患者作为研究对象,采用摸球法分为对照组与观察组,每组30例。对照组采用rt-PA静脉溶栓治疗,观察组在此基础上联合桥接Solitaire支架,比较两组血管再通率、再次栓塞率、神经功能、日常生活能力、预后情况、血清学指标、不良反应发生情况。结果治疗1、3个月,观察组血管再通率高于对照组,差异有统计学意义(P<0.05);观察组再次栓塞率低于对照组,差异有统计学意义(P<0.05)。治疗24 h、3个月,观察组美国国立卫生研究院卒中量表评分低于对照组,日常生活能力量表评分高于对照组,差异有统计学意义(P<0.05)。治疗1、3、6个月,观察组Rankin评分均低于对照组,差异有统计学意义(P<0.05)。治疗24 h,观察组C反应蛋白、神经元特异性烯醇化酶水平均低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论rt-PA静脉溶栓联合桥接Solitaire支架可有效提高CIS患者血管再通率,改善预后、血清学指标、神经功能和日常生活能力,降低不良反应发生率,值得临床推广应用。Objective To investigate the effect of recombinant human tissue-type plasminogen activator(rt-PA)intravenous thrombolysis combined with bridging Solitaire stent on vascular recanalization rate and neurological function recovery in patients with acute cerebral ischemic stroke(CIS).Methods A total of 60 CIS patients admitted to Pingxiang People's Hospital from January 2019 to December 2022 were selected as the research subjects,they were divided into the control group and the observation group by touching ball method,with 30 cases in each group.The control group was treated with rt-PA intravenous thrombolysis,and the observation group was combined with bridging Solitaire stent on this basis.The vascular recanalization rate,re-embolization rate,neurological function,daily living ability,prognosis,serological indicators and adverse reactions were compared between the two groups.Results After 1 and 3 months of treatment,the vascular recanalization rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).The re-embolization rate in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).After 24 h and 3 months of treatment,the National Institutes of Health stroke scale score in the observation group was lower than that in the control group,and the daily living ability scale score was higher than that in the control group,the differences were statistically significant(P<0.05).After 1,3 and 6 months of treatment,the Rankin score in the observation group was lower than that in the control group,the differences were statistically significant(P<0.05).After 24 h of treatment,the levels of Creactive protein and neuron-specific enolase in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group,the difference was statistically s

关 键 词：急性缺血性脑卒中 RT-PA静脉溶栓 桥接Solitaire支架 神经功能 血管再通 血清学指标 

分 类 号：R74[医药卫生—神经病学与精神病学]