阿替普酶与巴曲酶治疗急性脑梗死的疗效比较及对患者血清NSE、IL-6、TNF-α、hs—CRP水平的影响

Comparison of Therapeutic Effects of Batroxobin and Alteplase in Treatment of Acute Cerebral Infarction and Serum NSE, IL-6, TNF- α and hs-CRP Levels

目的：观察和比较阿替普酶（rt-PA）与巴曲酶治疗急性脑梗死（ACI）的临床效果及对患者血清神经元特异性烯醇化酶（NSE）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、超敏C反应蛋白（hs-CRP）水平的影响。方法：选取我院2014年6月-2016年12月收治的106例ACI患者，根据随机数字表法均分为两组。对照组予巴曲酶治疗，观察组给予rt-PA治疗。比较两组的临床疗效，治疗前后血清NSE、IL-6、TNF-α及hs-CRP水平的变化及治疗期间不良反应的发生情况。结果：治疗14d后，观察组的总有效率为81．1％。较对照组（62．3％）明显升高（P〈0．05）。两组治疗14d后血清NSE、IL-6、TNF-α及hs-CRP水平均较治疗前显著降低（P〈0．01），且观察组治疗14d后以上指标均显著低于对照组同期（P〈0．01）。观察组不良反应率为7．5％，与对照组（1．9％）对比差异无统计学意义（P〉0．05）。结论：与巴曲酶相比，阿替普酶静脉溶栓治疗急性脑梗死更能有效控制机体炎症状态，改善神经功能缺损，疗效更优，且安全性相当。

Objective： To observe and compare the clinical effect of alteplase （rt-PA） and batroxobin in the treatment of acute cerebral infarction （ACI） and its effects on the serum neuron specific enolase （NSE）, interleuldn-6 （IL-6）, tumor necrosis factor-α （TNFα） and high sensitive C reactive protein （hs-CRP） levels. Methods： 106 cases of ACI patients admitted in our hospital from June 2014 to December 2016 were selected and divided into two groups according to the random number table method. The control group was treated with batroxobin, while the observation group was treated with rt-PA. The clinical efficacy; changes of serum NSE, IL-6, TNF-α and hs-CRP levels before and after treatment and the incidence of adverse reactions during treatment were compared between two groups. Results： After 14days＇ treatment, the total effective rate of observation group was 81.1%, which was significantly higher than that of the control group （62.3%）（P〈0.05）. The serum NSE, IL-6, TNF-α and hs-CRP levels in both groups at 14 day after treatment were significantly lower than those before treatment （P〈0.01）, and the above indexes at 14 day after treatment in the observation group were significantly lower than those of control group in the same period （P〈0.01）. The incidence rate of adverse reactions was 7.5% in the observation group and compared with the control group （1.9%）, there was no significant difference （P〉0.05）. Conclusion： Compared with batroxobin, alteplase intravenous thrombolytic therapy could more effectively control the inflammation state and improve the nerve function defect for the patients with acute cerebral infarction.