摘要
目的研究静脉溶栓联合Solitaire AB可回收支架取栓治疗大血管闭塞的前循环缺血卒中的近远期疗效及对血浆内皮细胞特异性分子(Endocan)、血管内皮细胞钙黏蛋白(vascular endothelial-cadberin,VE-Ca)水平的影响。方法将2014年6月至2015年6月我院收治的120例前循环缺血卒中病人随机分为观察组和对照组,每组60例。观察组病人入院后立即进行阿替普酶静脉溶栓并联合Solitaire AB支架取栓,对照组病人直接进行Solitaire AB支架取栓。比较2组病人的临床指标、取栓后即刻血管再通率和并发症,比较2组术前、术后72 h、术后1周及术后30 d的NIHSS评分,比较2组术前和术后30 d血浆Endocan、VE-Ca水平及3年后的康复情况。结果观察组的取栓次数、取栓时间显著短于对照组,取栓失败率、植入支架率显著少于对照组,即刻血管再通率显著高于对照组,差异均具有统计学意义(P<0.05或P<0.01)。术后72 h、1周、30 d 2组NIHSS评分均显著下降,2组不同时间点比较,差异均有统计学意义(P<0.01);术后30 d 2组血浆Endocan、VE-Ca水平均显著下降,组间比较差异亦有统计学意义(P<0.05或P<0.01)。2组并发症发生率差异无统计学意义(P>0.05);术后3年观察组临床有效率显著高于对照组(P<0.05)。结论静脉溶栓联合Solitaire AB可回收支架取栓能有效提高血管再通率,减少支架植入,降低Endocan、VE-Ca水平,有利于血管内皮功能恢复和神经损伤恢复,提高远期疗效。
Objective To analyze the clinical effect of intravenous thrombolysis combined with Solitaire AB stent thrombectomy in the treatment of anterior circulation ischemic stroke and the influence on the levels of Endocan and vascular endothelial-cadberin(VE-Ca).Methods A total of 120 patients with anterior circulation ischemic stroke in our hospital from June 2014 to June 2015 were selected,and randomly divided into control group and observation group,with 60 cases in each group.The control group was treated with Solitaire AB stent thrombectomy directly.The observation group received ateplase intravenous thrombolysis combined with Solitaire AB stent thrombectomy.The clinical indicators,immediate vascular recanalization rate,complication,and the scores of the National Institutes of Health Stroke Scale(NIHSS)before treatment and 72 h,1 week and 30 d after operation were observed and compared between the two groups.The plasma levels of Endocan and VE-Ca before treatment and 30 d after operation,and the 3-year clinical efficacy were also compared between the two groups.Results The times and time of thrombectomy in the observation group were significantly less than those in the control group.The number of failed thrombectomy and stent implantation cases were significantly lower,and the immediate recanalization rate was significantly higher in the observation group than those in the control group(P<0.05 or P<0.01).The NIHSS score of the two groups decreased significantly 72 h,1 week and 30 d after operation,and there were significant differences between the two groups at different time points(P<0.01).The plasma levels of Endocan and VE-Ca 30 d after operation of the two groups decreased significantly,especially in the observation group(P<0.05 or P<0.01).There was no significant difference in the incidence of complications between the two groups(P>0.05).The clinical effective rate of the observation group was significantly higher than that of the control group three years after operation(P<0.05).Conclusions Intravenous thromb
作者
刘强
王娟娟
高喜斌
LIU Qiang;WANG Juan-juan;GAO Xi-bin(Department of Neurology,Yan'an University Affiliated Hospital,Yan'an 716000,China)
出处
《实用老年医学》
CAS
2020年第3期258-262,共5页
Practical Geriatrics
