重组组织型纤溶酶原激活剂静脉溶栓对急性脑梗死患者血清S100B蛋白的影响

Effect of rt-PA on S100B Protein in Patients with Acute Cerebral Infarction

目的:探讨重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗急性脑梗死(ACI)的疗效及安全性,以及对血清S100B蛋白的影响。方法:将发病<4.5h的ACI患者68例分为rt-PA组与对照组;对照组给予常规治疗,rt-PA组在常规治疗基础上给予rt-PA静脉溶栓治疗。检测68例ACI患者入院时及治疗后3、7、14d血清S100B蛋白水平和10例健康体检者(正常组)空腹血清S100B蛋白水平。分别于治疗前及治疗后90d,采用中国脑卒中临床神经功能缺损评分量表(CSS)及Barthel指数(BI)对患者进行评定,对比两组的疗效,并评价安全性。结果:入院时血清S100B蛋白水平比较,rt-PA组和对照组较正常组明显增高(P<0.01),rt-PA组和对照组比较差异无统计学意义(P>0.05),治疗3、7、14d后,rt-PA组和对照组血清S100B蛋白水平逐渐降低,且均较治疗前明显降低(P<0.01),rt-PA组降低更明显(P<0.01)。CSS评分和BI比较,治疗前rt-PA组与对照组比较差异无统计学意义(P>0.05),治疗后rt-PA组较对照组改善更明显,比较差异有统计学意义(P<0.01)。两组出血并发症发生率比较差异无统计学意义。结论:ACI发病4.5h内给予rt-PA静脉溶栓能显著降低血清S100B蛋白水平,治疗有效、安全。

Objective：To investigate the efficacy and safety of recombinant tissue-type plasminogen activator （ rt-PA ） in acute cerebral infarction （ ACI ）, and the effect to S100B Protein.Method：64 ACI patients （ stroke onset within 4.5 h ） were randomized into rt-PA and control groups.The control group were treated with conventional therapy, and the rt-PA group with additional rt-PA besides conventional therapy.The S100B Protein level were measured in 64 ACI patients on admission and 3, 7, 14 days after treatment and in 10 healthy patients （ normal group ） .The Chinese Stroke Scale （ CSS ） and the Barthel Index （ BI ） were used to evaluate the neurological functions before and 90 days after treatment.Result：On admission, the S100B Protein level in rt-PA and control groups were significantly higher than in normal group （ P〈0.01 ）, there was no significant difference between the rt-PA and control group （ P〉0.05 ）, the S100B Protein level was significantly lower 3, 7, 14 days after treatment in both groups （ P〈0.01 ）, and it was significantly lower in rt-PA group than in control group （ P〈0.01 ） .CSS scores and BI of the rt-PA group and the control group showed no significant difference before treatment （ P〉0.05 ） and were significantly different after treatment （ P〈0.01 ） .The bleeding complication rate was no significant different in two groups （ P〉0.05 ） .Conclusion：Intravenous rt-PA thrombolysis within 4.5 h from onset can significantly reduce S100B Protein level and is effective and safe in ACI patients.