阿替普酶溶栓序贯低分子肝素钙抗栓对脑梗死患者神经功能及血清细胞因子的影响

Effect of alteplase thrombolysis sequenced by low-molecular-weight heparin calcium antithrombosis on the neurological function and serum cytokines in patients with cerebral infarction

目的:研究阿替普酶溶栓序贯低分子肝素钙抗栓对脑梗死患者神经功能及血清细胞因子的影响。方法:回顾性分析在本院接受阿替普酶溶栓治疗的急性脑梗死患者,分为接受低分子肝素钙治疗的干预组和未接受低分子肝素钙治疗的对照组。治疗前后采集血清并测定血小板活化因子、神经损伤分子、可溶性凋亡分子、生长因子的含量。结果:两组患者治疗后血清中CD62p、CD63、PAF、GMP-140、NSE、S100B、GFAP、sFas、sFasL、sTRAIL、IGF-1、VEGF、BDNF、bFGF的含量均低于治疗前(P<0.05)且干预组患者治疗后血清中CD62p、CD63、PAF、GMP-140、NSE、S100B、GFAP、sFas、sFasL、sTRAIL的含量均低于对照组,IGF-1、VEGF、BDNF、bFGF的含量高于对照组(P<0.05)。结论:阿替普酶溶栓序贯低分子肝素钙抗栓治疗急性脑梗死能够抑制血小板活化、细胞凋亡并减轻神经功能损伤、改善神经营养状态。

Objective： To study the effect of alteplase thrombolysis sequenced by low-molecular-weight heparin calcium antithrombosis on the neurological function and serum cytokines in patients with cerebral infarction. Methods： Patients with acute cerebral infarction who received alteplase thrombolysis in Zigong Municipal Fourth People＇s Hospital between June 2014 and October 2016 were retrospectively analyzed and divided into the intervention group who received low-molecular-weight heparin calcium treatment and the control group who did not receive low-molecular-weight heparin calcium treatment. The serum was collected before and after treatment to determine the Contents of platelet activation factors, nerve injury molecules, soluble apoptotic molecules and growth factors. Results： Serum CD62p, CD63, PAF, GMP-140, NSE, S100B, GFAP, sFas, sFasL, sTRAIL, IGF-1, VEGF, BDNF and bFGF levels of both groups of patients after treatment were lower than those before treatment （P〈0.05）,serum CD62p, CD63, PAF, GMP-140, NSE, S100B, GFAP, sFas, sFasL and sTRAIL levels of intervention group after treatment were lower than those of control group while IGF-1, VEGF, BDNF and bFGF levels were higher than those of control group （P〈0.05）. Conclusion：Alteplase thrombolysis sequenced by low-molecular-weight heparin calcium antithrombosis for acute cerebral infarction can inhibit platelet activation and cell apoptosis, alleviate nerve injury and improve neurotrophy status.