摘要
目的 探讨重组型组织型纤溶酶原激活剂静脉溶栓联合尤瑞克林注射液对急性脑梗死患者脑血流动力学及外周血Toll样受体的影响.方法 将108例急性脑梗死患者按随机数字表法分为两组,每组54例.两组均予以重组型组织型纤溶酶原激活剂静脉溶栓治疗,观察组在此基础上联合尤瑞克林注射液治疗,观察2周.统计两组临床疗效、不良反应,于治疗前后检测血液流变学指标(全血低切黏度、红细胞聚集指数、全血高切黏度)、脑血流动力学指标(双侧大脑中动脉、椎动脉的平均峰流速、收缩期峰流速)、外周血Toll样受体、高敏C反应蛋白、可溶性细胞间黏附分子.结果 观察组治疗总有效率显著高于对照组(P<0.01).治疗后观察组血液流变学指标(全血低切黏度、全血高切黏度、红细胞聚集指数)水平显著低于对照组(P<0.01),脑血流动力学指标(双侧大脑中动脉、椎动脉的平均峰流速、收缩期峰流速)显著高于对照组(P<0.01),炎性细胞因子(外周血可溶性细胞间黏附分子、高敏C反应蛋白、Toll样受体)水平显著低于对照组(P<0.01).两组不良反应发生率比较差异无统计学意义(P>0.05).结论 重组型组织型纤溶酶原激活剂静脉溶栓联合尤瑞克林注射液可下调急性脑梗死患者外周血Toll样受体水平,恢复脑血流动力学,改善血液流变学指标,提高治疗效果,安全性较高.
Objective To investigate the effects of rt-PA iptravenous throm bolysis combined with Ureklin injection on cerebral hemodynamics and peripheral blood TLR4 in patients with acute cerebral infarction.Methods A total of 108 patients with ACI were divided into control group(n=54)and observation group(n=54)respectively,according to random number table method.Both groups were treated with rt-PA in-travenous thrombolysis,and the observation group was treated with Ureklin injection on this basis for 2 weeks.The two groups were evaluated for efficacy and adverse reactions.The blood rheology indexes(low blood viscosity,RCA,whole blood high shear viscosity)before and after treatment,cerebral hemo-dynamics index(MCA,Vm,VA,Vs)during systole,peripheral blood TLR4,high-sensitivity C-reactive protein(hs-CRP),soluble intercellular adhesion molecule(sICAM-1)were compared.Results The total effective rate of treatment in the observation group was significantly higher than that in the control group(P<0.01).After treatment,the observation group's blood rheology indexes(whole blood low shear vis-cosity,whole blood high shear viscosity,RCA)levels were significantly lower than those of the control group(P<0.01),and cerebral hemodynamic indexes(MCA,Vm,VA,Vs)Was significantly higher than the control group(P<0.01),and the level of inflammatory cytokines(peripheral blood sICAM-1,high-sensitivity C-reactive protein,Toll-like re-ceptor)was lower than the control group(P<0.01).Conclusions rt-PA intravenous thrombolysis combined with Ureklin injection can down-regulate the level of peripheral blood Tol-like receptors in patients with acute cerebral infarction,restore cerebral hemody-namics,improve blood rheology indexes,and improve the therapeutic effect with high safety.
作者
田婧
白永杰
尤爱民
Tian Jing;Bai Yongjie;You Aimin(The First Affiliated Hospital of Henan Universily of Science and Technology,Luoyang 471000.Henan,China)
出处
《临床心身疾病杂志》
CAS
2020年第6期20-24,共5页
Journal of Clinical Psychosomatic Diseases
基金
河南省医学科技攻关计划联合共建项目(编号201802077)。
