明复乐治疗急性致残性非大血管脑梗死的临床效果及对氧化应激与炎性反应及神经功能的影响  

Clinical effect of recombinant human TNK tissue-type plasminogen activator for injection in the treatment of acute disabling non-macrovascular cerebral infarction and its effect on oxidative inflammation and neurological function in patients

作　　者：杨进平[1] 袁磊[1] 闻瑛 陈后勤[1] YANG Jinping;YUAN Lei;WEN Ying;CHEN Houqin(Taicang Affiliated Hospital of Nanjing University of Traditional Chinese Medicine/Taicang Traditional Chinese Medicine Hospital,Jiangsu Province,Taicang 215400,China;不详)

机构地区：[1]南京中医药大学太仓附属医院/太仓市中医医院,江苏省太仓市215400

出　　处：《临床合理用药》2025年第9期5-9,共5页Chinese Journal of Clinical Rational Drug Use

基　　金：2021年苏州市科技发展计划(医疗卫生科技创新—应用基础研究)(SKJYD2021012);2022年苏州市中医重点专科项目(20221025);2022年太仓市卫生人才计划项目(20220305);2023年苏州卫生青年骨干人才“全国导师培训项目”(Qngg2023044)。

摘　　要：目的观察重组人TNK组织型纤溶酶原激活剂(明复乐)治疗急性致残性非大血管脑梗死的临床效果及对氧化应激与炎性反应及神经功能的影响。方法回顾性选取2022年1月—2023年12月南京中医药大学太仓附属医院/太仓市中医医院收治的急性致残性非大血管脑梗死患者80例,根据治疗方案不同分为静脉溶栓组(n=40)与阿司匹林组(n=40)。阿司匹林组给予阿司匹林肠溶片治疗,静脉溶栓组给予注射用重组人TNK组织型纤溶酶原激活剂(明复乐)治疗。比较2组临床疗效,溶栓前与溶栓后7、14 d氧化应激指标[超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)]、血清炎性因子[白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)],溶栓前与溶栓后2 h、24 h、7 d、14 d美国国立卫生院卒中量表(NIHSS)评分,不良事件。结果静脉溶栓组治疗总有效率为92.50%,高于阿司匹林组的45.00%(χ^(2)=21.004,P<0.001)。溶栓后7、14 d,2组血清SOD、GSH-Px水平高于溶栓前,血清MDA水平低于溶栓前,且静脉溶栓组升高/降低幅度大于阿司匹林组(P<0.01);2组血清IL-6、hs-CRP、TNF-α水平低于溶栓前,且静脉溶栓组低于阿司匹林组(P<0.01)。溶栓后2 h、24 h、7 d、14 d,2组NIHSS评分低于溶栓前,且静脉溶栓组低于阿司匹林组(P<0.01)。静脉溶栓组不良事件总发生率与阿司匹林组比较,差异无统计学意义(5.00%vs.10.00%,χ^(2)=0.180,P=0.671)。结论明复乐静脉溶栓可促进急性致残性非大血管脑梗死患者血管再通,降低氧化应激反应和炎性反应,减轻神经功能缺损,提高临床疗效同时,且安全性较高。Objective To observe the clinical effect of recombinant human TNK tissue-type plasminogen activator for injection in the treatment of acute disabling non-macrovascular cerebral infarction and its effect on oxidative inflammation and neurological function in patients.Methods A total of 80 patients with acute disabling non-macrovascular cerebral infarction from Taicang Affiliated Hospital of Nanjing University of Traditional Chinese Medicine/Taicang Traditional Chinese Medicine Hospital from January 2022 to December 2023 were retrospectively enrolled and divided into the intravenous thrombolysis group(n=40)and the aspirin group(n=40)according to different treatment regimens.The aspirin group was treated with aspirin enteric-coated tablets,and the intravenous thrombolysis group was treated with recombinant human TNK tissue-type plasminogen activator for injection.Clinical efficacy,oxidative stress indexes(SOD,GSH-Px,MDA),serum inflammatory factors(IL-6,TNF-α,hs-CRP)before and 7,14 days after thrombolysis,NIHSS scores before and 2,24 hours,and 7,14 days after thrombolysis,and adverse events were compared between the two groups.Results The total effective rate of treatment in the intravenous thrombolysis group was 92.50%,which was higher than 45.00%in the aspirin group(χ^(2)=21.004,P<0.001).At 7 and 14 days after thrombolysis,serum levels of SOD and GSH-Px in the two groups were higher than those before thrombolysis,and the serum level of MDA was lower than that before thrombolysis,the increase/decrease range in the intravenous thrombolysis group was greater than that in the aspirin group(P<0.01).Serum levels of IL-6,hs-CRP and TNF-αin the two groups were lower than those before thrombolysis,and those in the intravenous thrombolysis group were lower than those in the aspirin group(P<0.01).At 2,24 hours,7 and 14 days after thrombolysis,NIHSS scores in the two groups were lower than those before thrombolysis,and the intravenous thrombolysis group was lower than the aspirin group(P<0.01).There was no significant diffe

关 键 词：急性脑梗死 静脉溶栓 重组人TNK组织型纤溶酶原激活剂 氧化应激炎性反应 神经功能 

分 类 号：R74[医药卫生—神经病学与精神病学]