不同剂量重组组织型纤溶酶原激活剂联合双抗治疗轻型急性缺血性脑卒中的效果  

Effect of Different Doses of Recombinant Tissue Plasminogen Activator Combined with Dual Antiplatelet in the Treatment of Patients with Mild Acute Ischemic Brain Stroke

作　　者：金玲 周昊[1] JIN Ling;ZHOU Hao(Neurology Department,Beijing Boai Hospital,Beijing 100068,China;不详)

机构地区：[1]北京博爱医院神经内科,北京100068

出　　处：《中国医学创新》2025年第12期131-135,共5页Medical Innovation of China

摘　　要：目的:观察及比较不同剂量重组组织型纤溶酶原激活剂联合双抗治疗轻型急性缺血性脑卒中的效果。方法:选择2022年5月—2024年8月北京博爱医院收治的90例轻型急性缺血性脑卒中患者,根据随机数字表法分为两组,各45例。A组给予常规剂量(0.9 mg/kg)重组组织型纤溶酶原激活剂联合双抗治疗,B组给予小剂量(0.7 mg/kg)重组组织型纤溶酶原激活剂联合双抗治疗。比较两组治疗总有效率、不良反应发生率及治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、氧化应激指标[谷胱甘肽过氧化物酶(GSH-Px)、氧化型低密度脂蛋白(ox-LDL)及丙二醛(MDA)]与炎症反应指标[超敏C反应蛋白(hs-CRP)、白细胞介素-17(IL-17)及白细胞介素-1β(IL-1β)]。结果:两组治疗总有效率比较,差异无统计学意义(P>0.05)。B组不良反应发生率显著低于A组,差异有统计学意义(P<0.05)。治疗后3、7 d,两组GSH-Px均显著高于治疗前,NIHSS评分、ox-LDL、MDA、hs-CRP、IL-17、IL-1β均显著低于治疗前,差异均有统计学意义(P<0.05);治疗前及治疗后3、7 d,两组NIHSS评分、氧化应激指标与炎症反应指标比较,差异均无统计学意义(P>0.05)。结论:小剂量重组组织型纤溶酶原激活剂联合双抗治疗轻型急性缺血性脑卒中的效果及对氧化应激与炎症反应水平的影响与常规治疗剂量无显著差异,但安全性更高。Objective:To observe and compare the effect of different doses of recombinant tissue plasminogen activator combined with dual antiplatelet in the treatment of mild acute ischemic brain stroke.Method:A total of 90 patients with mild acute ischemic brain stroke admitted to Beijing Boai Hospital from May 2022 to August 2024 were selected and divided into two groups according to random number table method,with 45 cases in each group.Group A was treated with conventional dose(0.9 mg/kg)of recombinant tissue plasminogen activator combined with dual antiplatelet,group B was treated with low dose(0.7 mg/kg)of recombinant tissue plasminogen activator combined with dual antiplatelet.The total effective rate,incidence of adverse reactions,national institutes of health stroke scale(NIHSS)score,oxidative stress index[glutathione peroxidase(GSH-Px),oxidized low density lipoprotein(ox-LDL)and malonaldehyde(MDA)]and inflammatory response index[high-sensitivity C reactive protein(hs-CRP),interleukin-17(IL-17)and interleukin-1β(IL-1β)]were compared between the two groups.Result:There was no significant difference in the total effective rate between the two groups(P>0.05).The incidence of adverse reactions in group B was significantly lower than that in group A,the difference was statistically significant(P<0.05).At 3,7 d after treatment,GSH-Px in two groups were significantly higher than those before treatment,and NIHSS score,ox-LDL,MDA,hs-CRP,IL-17 and IL-1βwere significantly lower than those before treatment,the differences were statistically significant(P<0.05).There were no significant differences in NIHSS score,oxidative stress indexes and inflammatory response indexes between the two groups before treatment and at 3,7 d after treatment(P>0.05).Conclusion:The effect of low dose of recombinant tissue plasminogen activator combined with dual antiplatelet in the treatment of patients with mild acute ischemic brain stroke and influence on oxidative stress and inflammatory response levels show no significant difference compared

关 键 词：重组组织型纤溶酶原激活剂 双抗 轻型急性缺血性脑卒中 氧化应激 炎症反应 

分 类 号：R743.3[医药卫生—神经病学与精神病学]