摘要
目的探讨阿替普酶序贯依达拉奉治疗急性缺血性脑卒中(acute ischemic stroke,AIS)的临床疗效。方法选取本院2015年3月至2018年3月收治的91例AIS患者,根据治疗方法分为对照组(42例)和观察组(49例),对照组采用阿替普酶溶栓联合阿司匹林、氯吡格雷治疗,观察组采用阿替普酶溶栓序贯依达拉奉联合阿司匹林、氯吡格雷治疗。对比两组临床疗效、出血转化情况,观察两组治疗前后美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分、改良RANKIN量表(modified RANKIN scale,MRS)评分、血清神经元特异性烯醇化酶(neuron-specific enolase,NSE)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、低氧诱导因子-1α(hypoxia inducible factor-1α,HIF-1α)水平。结果两组治疗后NIHSS评分及MRS评分较治疗前均显著降低,且观察组低于对照组(P<0.05);观察组治疗后总有效率为83.67%,显著高于对照组69.05%(P<0.05);观察组和对照组出血转化发生率分别为8.16%、19.05%,观察组显著低于对照组(P<0.05);两组治疗后血清NSE、TNF-α、HIF-1α水平较治疗前均明显降低,且观察组低于对照组(P<0.05)。观察组和对照组治疗期间不良反应总发生率为10.20%、14.29%,差异无统计学意义(P>0.05)。结论阿替普酶序贯依达拉奉治疗AIS的疗效显著,能有效改善患者神经功能,减少出血性转化和降低血清NSE、TNF-α、HIF-1α水平。
Objective To investigate the clinical effect of alteplase sequenced by edaravone in treatment of acute ischemic stroke(AIS).Methods 91 cases of AIS patients admitted to our hospital from March 2015 to March 2018 were selected and divided into control group(42 cases)and observation group(49 cases)according to the treatment methods.The control group received alteplase thrombolysis combined with aspirin and clopidogrel,the observation group received alteplase thrombolysis sequential by edaravone combined with aspirin and clopidogrel.The clinical efficacy and bleeding transformation of two groups were compared.The NIHSS score,modified RANKIN scale(MRS)score,serum Neuron-specific enolase(NSE),Tumor necrosis factor-α(TNF-α)and Hypoxia inducible factor-1α(HIF-1α)were observed before and after treatment in two groups.Results NIHSS score and MRS score of two groups were significantly reduced after treatment and the observation group was lower than control group(P<0.05).The total effective rate of observation group was 83.67%,which was significantly higher than control group 69.05%(P<0.05).The incidence of bleeding transformation in observation group and control group was 8.16%and 19.05%,respectively,the observation group were significantly lower than control group(P<0.05).Serum NSE,TNF-αand HIF-1αlevels were significantly reduced in two groups and the observation group was lower than in control group(P<0.05).The total incidence of adverse reactions during treatment in observation group and control group was 10.20%and 14.29%,with no statistically significant difference(P>0.05).Conclusion Alteplase sequenced by edaravone has a significant effect on the treatment of AIS.It can effectively improve the neurological function,reduce hemorrhagic transformation and serum NSE,TNF-α,HIF-1α.
作者
陈烈冉
付国惠
刘娜
张保朝
Chen Lieran;Fu Guohui;Liu Na;Zhang Baochao(Department of Neurology,the Nanyang Central Hospital,Henan 473009,China)
出处
《脑与神经疾病杂志》
2020年第8期507-511,共5页
Journal of Brain and Nervous Diseases
基金
河南省科技攻关计划项目(201805203)
