rt-PA静脉溶栓联合丹参多酚酸盐治疗急性脑梗死的临床观察

Clinical Observation of rt-PA Intravenous Thrombolysis Combined with Salvianolate in the Treatment of Acute Cerebral Infarction

目的:探讨rt-PA静脉溶栓联合丹参多酚酸盐治疗急性脑梗死的临床效果.方法:选择2015年1月—2018年1月我院收治的急性脑梗死患者200例,根据治疗方法不同分为对照组和观察组,各100例.对照组采用rt-PA静脉溶栓治疗,观察组在对照组基础上联合丹参多酚酸盐(200 mg混合250 mL 0.9% 氯化钠注射液中静脉滴注,qd)治疗,两组均连续治疗7 d.比较两组治疗前、治疗24 h、3 d及7 d后美国国立卫生研究院卒中量表(NIHSS)评分;采用酶联免疫吸附试验测定两组治疗前、治疗后7 d超敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6及IL-1β 水平;比较两组治疗7 d后颅内出血、症状性颅内出血、心力衰竭、肺部感染及死亡率.结果:治疗24 h、3 d及7 d后两组NIHSS量表评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗7 d后观察组hs-CRP、TNF-α、IL-6和IL-1β 水平均低于对照组,差异有统计学意义(P<0.05);观察组治疗7 d后颅内出血、症状性颅内出血、心力衰竭、肺部感染及死亡发生率均低于对照组,差异有统计学意义(P<0.05).结论:rt-PA静脉溶栓联合丹参多酚酸盐治疗急性脑梗死能减轻患者神经功能缺损,降低炎症因子水平,改善患者预后,值得推广应用.

Objective:To investigate the clinical effect of rt-PA intravenous thrombolysis combined with Salvianolate in the treatment of acute cerebral infarction.Methods:200 patients with acute cerebral infarction admitted to our hospital from January 2015 to January 2018 were selected and divided into a control group and an observation group according to different treatment methods,100 cases each.The patients in the control group were treated with rt-PA intravenous thrombolysis,and the patients in the observation group were further treated with Salvianolate(200 mg drug was mixed with 250 mL 0.9%sodium chloride injection,intravenous drip,qd).The patients in the two groups were continuously treated for 7 days.The scores of the National Institute of Health Stroke Scale(NIHSS)before treatment and after 24 h,3 days and 7 days of treatment were compared between the two groups.The levels of hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor(TNF)-α,interleukin(IL)-6 and IL-1βbefore treatment and after 7 days of treatment were measured by enzymelinked immunosorbent assay.Intracranial hemorrhage,symptomatic intracranial hemorrhage,heart failure,pulmonary infections and mortality after 7 days of treatment were compared between the two groups.Results:The scores of NIHSS after 24 h,3 days and 7 days of treatment were lower than those before treatment in the two groups,and the scores in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).After 7 days of treatment,the levels of hs-CRP,TNF-α,IL-6 and IL-1βin the observation group were lower than those in the control group,with statistically significant differences(P<0.05).After 7 days of treatment,the incidences of intracranial hemorrhage,symptomatic intracranial hemorrhage,heart failure,pulmonary infections and death in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).Conclusion:rt-PA intravenous thrombolysis combined with Salvianolate polyphenolate can alleviate neurological deficits,reduce the levels of inflammatory factors and improve the prognosis of the patients in the treatment of acute cerebral infarction,which is worthy of popularization and application.