阿替普酶溶栓治疗对脑梗死患者神经损伤及血清细胞因子的影响

Effect of alteplase thrombolysis on nerve injury and serum cytokines in patients with cerebral infarction

目的:研究阿替普酶溶栓治疗对脑梗死患者神经损伤及血清细胞因子的影响。方法:选择2014年5月~2016年10月期间在东方医院接受溶栓治疗的急性脑梗死病例进行回顾性分析,根据溶栓方案不同分为rt-Pa组、UK组,分别接受阿替普酶溶栓、尿激酶溶栓。溶栓治疗前及治疗后1、7d,检测血清中神经损伤标志物、神经细胞因子、炎症细胞因子的含量。结果:溶栓治疗后1、7d时,两组患者血清中神经损伤标志物NSE、S100B、MDA、8-OHdG以及炎症细胞因子IL-1β、IL-18、TNF-α、sVCAM-1的含量较治疗前显著降低,神经细胞因子BDNF、NGF、VEGF的含量较治疗前显著升高且rt-Pa组患者血清中神经损伤标志物NSE、S100B、MDA、8-OHdG以及炎症细胞因子IL-1β、IL-18、TNF-α、sVCAM-1的含量较UK组显著降低,神经细胞因子BDNF、NGF、VEGF的含量较UK组显著升高。结论:阿替普酶溶栓治疗急性脑梗死能够减轻神经功能损伤、改善神经营养状态、抑制炎症反应。

Objective:To study the effect of alteplase thrombolysis on nerve injury and serum cytokines in patients with cerebral infarction.Methods:Patients with acute cerebral infarction who received thrombolytic therapy in Dongfang Hospital between May2014and October2016were retrospectively analyzed,and according to the different ways of thrombolysis,they were divided into rt Pa group and UK group who accepted alteplase and urokinase thrombolysis respectively.Serum levels of nerve injury markers,nerve cytokines and inflammatory cytokines were detected before as well as1d and7d after thrombolytic therapy.Results:1d and7d after thrombolysis,serum nerve injury markers NSE,S100B,MDA and8OHdG as well as inflammatory cytokines IL1β,IL18,TNFαand sVCAM1levels of both groups of patients were significantly lower than those before treatment while nerve cytokines BDNF,NGF and VEGF levels were significantly higher than those before treatment,and serum nerve injury markers NSE,S100B,MDA and8OHdG as well as inflammatory cytokines IL1β,IL18,TNFαand sVCAM1levels of rt Pa group were significantly lower than those of UK group while nerve cytokines BDNF,NGF and VEGF levels were significantly higher than those of UK group.Conclusion:Alteplase thrombolysis for acute cerebral infarction can reduce nerve injury,improve neurotrophic state,and inhibit inflammatory response.