摘要
目的探究尤瑞克林在前循环急性大血管闭塞性卒中(ALVOS)病人机械取栓术后的应用及对预后的影响。方法选取2018年8月至2020年12月驻马店市中心医院入院就诊的ALVOS病人74例,采用随机数字表法分为对照组和观察组,各37例。对照组采用机械取栓法治疗,观察组在对照组基础上加用尤瑞克林治疗14 d,比较两组血液流变学、同型半胱氨酸(Hcy)、胱抑素(Cys)-C、基质金属蛋白酶-9(MMP-9)、超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、美国国立卫生研究院卒中量表(NIHSS)评分、日常生活能力评定(Barthel指数)及90 d病死率。结果治疗前,两组病人血液流变学指标[血浆黏度(PV)、全血低切黏度(LWBV)、全血高切黏度(HWBV)、纤维蛋白原(FIB)]、Hcy、Cys-C、MMP-9、hs-CRP、IL-6、TNF-α水平比较,差异无统计学意义(P>0.05);治疗后,两组PV(1.37±0.41,1.74±0.52)mPs/s、LWBV(3.68±1.05,4.33±1.17)mPs/s、HWBV(6.35±1.38,8.75±1.59)mPs/s、FIB(249.55±21.69,289.62±26.48)g/L、Hcy(11.36±2.68,17.59±3.24)μmol/L、Cys-C(0.81±0.21,1.26±0.29)mg/L、MMP-9(246.33±22.98,282.57±25.54)μg/L、hs-CRP(10.21±2.25,14.47±2.68)mmol/L、IL-6(8.45±2.78,13.61±3.37)ng/L、TNF-α(7.54±2.30,11.73±3.18)ng/L较治疗前均显著降低(P<0.05),且观察组上述指标改善程度明显优于对照组(P<0.05)。治疗前,两组病人NHISS评分、Barthel指数比较,差异无统计学意义(P>0.05);治疗后24 h、治疗后7 d、治疗后90 d,两组NHISS评分24 h(10.41±2.26,11.35±2.51)分、7 d(5.29±1.34,7.92±1.58)分和90 d(1.62±0.52,1.95±0.58)分较治疗前明显改善(P<0.05),且观察组治疗后7 d、治疗后90 d NHISS评分低于对照组(P<0.05);治疗后、治疗后90 d,两组Barthel指数(73.55±15.24,59.64±12.67)分和90 d(78.63±14.47,62.30±13.15)分较治疗前明显改善(P<0.05),且观察组Barthel指数高于对照组(P<0.05)。治疗后90 d内两组均未有死亡病例。结论ALVOS病人机械取栓术后�
Objective To explore the application and prognostic effect of urinary kallidinogenase in patients with acute large vascular occlusion stroke(ALVOS)of the anterior circulation after mechanical thrombectomy.Methods A total of 74 patients with ALVOS admitted to the Zhumadian Central Hospital from August 2018 to December 2020 were selected and divided into a control group and an observation group using the random number table method,with 37 cases each.The control group was treated with mechanical thrombectomy,and the observation group was treated with urinary kallidinogenaseon on the basis of the control group.The hemorheology,homocysteine(Hcy),cystatin C(Cys-C),matrix metalloproteinase-9(MMP-9),high-sensitivity C-reactive protein(hs-CRP),interleukin 6(IL-6),tumor necrosis factorα(TNF-α),National Institutes of Health Stroke Scale(NIHSS)score,assessment of daily living ability(Barthel index)and 90-d mortality rate were compared between the two groups.Results Before treatment,there were no statistically significant differences in the levels of hemorheology indices[plasma viscosity(PV),low-cut whole blood viscosity(LWBV),high-cut whole blood viscosity(HWBV),fibrinogen(FIB)],Hcy,Cys-C,MMP-9,hs-CRP,IL-6 and TNF-αwhen compared between the two groups of patients(P>0.05).After treatment,PV(1.37±0.41,1.74±0.52)mPs/s,LWBV(3.68±1.05,4.33±1.17)mPs/s,HWBV(6.35±1.38,8.75±1.59)mPs/s,FIB(249.55±21.69,289.62±26.48)g/L,Hcy(11.36±2.68,17.59±3.24)μmol/L,Cys-C(0.81±0.21,1.26±0.29)mg/L,MMP-9(246.33±22.98,282.57±25.54)μg/L,hs-CRP(10.21±2.25,14.47±2.68)mmol/L,IL-6(8.45±2.78,13.61±3.37)ng/L and TNF-α(7.54±2.30,11.73±3.18)ng/L in both groups were significantly lower than before treatment(P<0.05),and the improvement of the above indices in the observation group was significantly better than that in the control group(P<0.05).Before treatment,there was no significant difference in the NIHSS score or Barthel index between the two groups(P>0.05).The NIHSS scores[24 h(10.41±2.26 vs.11.35±2.51)points,7 d(5.29±1.34 vs.7.9
作者
张昊
高立功
谭文刚
冯文献
于广周
ZHANG Hao;GAO Ligong;TAN Wengang;FENG Wenxian;YU Guangzhou(The Third Department of Neurology,Zhumadian Central Hospital,Zhumadian,Henan 463000,China)
出处
《安徽医药》
CAS
2023年第2期409-413,共5页
Anhui Medical and Pharmaceutical Journal
关键词
脑梗死
卒中
颅内栓塞和血栓形成
血栓切除术
颈内动脉
尤瑞克林
机械取栓
预后
Brain infarction
Stroke
Intracranial embolism and thrombosis
Thrombectomy
Carotid artery,internal
Urinary kallidinogenase
Mechanical thrombectomy
Prognosis
