DSA引导下神经介入溶栓术联合静脉溶栓治疗缺血性脑卒中的效果观察  

Effect of DSA-guided neurointerventional thrombolysis combined with intravenous thrombolysis in the treatment of ischemic stroke

作　　者：王云飞 王瑞瑞 马雪敏 杨琳潞 Wang Yunfei;Wang Ruirui;Ma Xuemin;Yang Linlu(Center of Interventional Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院介入手术中心,郑州450000

出　　处：《中国实用医刊》2025年第1期1-4,共4页Chinese Journal of Practical Medicine

摘　　要：目的观察数字减影血管造影(DSA)引导下神经介入溶栓术联合静脉溶栓治疗缺血性脑卒中的效果。方法前瞻性抽取2020年6月至2023年6月于郑州大学第一附属医院进行治疗的缺血性脑卒中患者50例,按随机数字表法分为对照组和观察组,每组25例。对照组采用静脉溶栓治疗,观察组采用静脉溶栓联合DSA引导下神经介入溶栓术治疗。比较两组临床疗效;比较两组治疗前后脑血管血流动力学指标[脑血管平均血流量(Qmean)、脉搏波传导速度(PWV)、血管特性阻抗(ZCV)、外周阻力(Rv)],血清一氧化氮(NO)、神经轴突导向因子-1(Netrin-1)、血管内皮生长因子(VEGF)水平及神经功能[采用美国国立卫生院卒中量表(NIHSS)评价]。结果观察组总有效率(96.00%,24/25)高于对照组(68.00%,17/25),P<0.05。治疗3个月后,观察组Qmean高于对照组,PWV、ZCV、Rv低于对照组(P<0.05)。治疗3个月后,观察组NO、Netrin-1、VEGF水平高于对照组(P<0.05);治疗3个月后,观察组NIHSS评分低于对照组(P<0.05)。结论DSA引导下神经介入溶栓术联合静脉溶栓治疗缺血性脑卒中可有效提高疗效,改善患者脑血管血流动力学指标,改善血清NO、Netrin-1、VEGF水平及神经功能。ObjectiveTo observe the effect of digital subtraction angiography(DSA)guided neurointerventional thrombolysis combined with intravenous thrombolysis in the treatment of ischemic stroke.MethodsA total of 50 patients with ischemic stroke who were treated in the First Affiliated Hospital of Zhengzhou University from June 2020 to June 2023 were prospectively selected,and they were divided into the control group and the observation group according to the random number table method,with 25 cases in each group.The control group was treated by intravenous thrombolysis,the observation group was treated by intravenous thrombolysis combined with DSA-guided neurointerventional thrombolysis.The clinical efficacy of the two groups were compared.The cerebrovascular hemodynamics indexes,including cerebral mean blood flow(Qmean),pulse wave velocity(PWV),cerebrovascular characteristic impedance(ZCV)and peripheral resistance(Rv),the serum levels of nitric oxide(NO),netrin-1 and vascular endothelial growth factor(VEGF),and neurological function assessed by the National Institutes of Health stroke scale(NIHSS)were compared between the two groups before and after treatment.ResultsThe total effective rate of the observation group(96.00%,24/25)was higher than that of the control group(68.00%,17/25),P<0.05.After 3 months of treatment,Qmean in the observation group was higher than that in the control group,while PWV,ZCV and Rv were lower than those in the control group(P<0.05).After 3 months of treatment,the levels of NO,netrin-1 and VEGF in the observation group were higher than those in the control group(P<0.05).After 3 months of treatment,the NIHSS score of the observation group was lower than that of the control group(P<0.05).ConclusionsNeurointerventional thrombolysis guided by DSA combined with intravenous thrombolysis can effectively promote the clinical efficacy,improve hemodynamics indexes,improve serum levels of NO,netrin-1 and VEGF,and improve the nerve function of ischemic stroke patients.

关 键 词：数字减影血管造影 神经介入溶栓术 静脉溶栓 缺血性脑卒中 

分 类 号：R743.3[医药卫生—神经病学与精神病学]