注射用丹参多酚酸联合阿替普酶对急性脑梗死患者疗效及血管内皮功能和炎症因子的影响

Effect of Salvianolic Acids for Injection combined with alteplase on vascular endothelial function and inflammatory factor in patients with acute cerebral infarction

目的 探讨注射用丹参多酚酸联合阿替普酶对急性脑梗死患者疗效及血管内皮功能和炎症因子的影响.方法 选择2017年2月-2019年2月期间安阳市第二人民医院接受诊治的急性脑梗死患者78例,采用随机表法分为治疗组、对照组,各39例.对照组通过静脉通路给予阿替普酶溶栓治疗,剂量为0.9 mg/kg,最大剂量为每日90 mg;治疗组在对照组基础上结合注射用丹参多酚酸0.13g+250mL的0.9%氯化钠注射液,1次/d.两组疗程均为2周.比较两组治疗疗效,治疗前后日常生活活动能力(ADL)评分和神经功能缺损程度(NIHSS)评分、血管内皮功能和炎症因子变化,及不良反应情况.结果 治疗后治疗组总有效率(92.31%)高于对照组(71.79%);两组治疗后血清超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α (TNF-α)和白介素-1β (IL-1β)含量较治疗前降低(P<0.05),且治疗组低于对照组(P<0.05).两组治疗后血浆ET-1含量较治疗前降低而血浆NO含量较治疗前升高(P<0.05),且治疗组改善优于对照组(P<0.05);两组治疗后ADL评分和NIHSS评分较治疗前均有改善,且治疗组评分改善优于对照组(P<0.05).两组均未发生明显不良反应.结论 注射用丹参多酚酸联合阿替普酶对急性脑梗死患者疗效良好,可改善血管内皮功能紊乱及减轻炎症反应,具有重要研究意义.

Objective To investigate the effect of Salvianolic Acids for Injection combined with alteplase on vascular endothelial function and inflammatory factors in patients with acute cerebral infarction.Methods A total of 78 patients with acute cerebral infarction treated in Anyang Second People's Hospital from February 2017 to February 2019 were randomly divided into treatment group and control group with 39 cases in each group.The control group was treated by intravenous thrombolysis with alteplase at a dose of 0.9 mg/kg and a maximum dose of 90 mg/d,while the treatment group was treated once a day with Salvianolic Acids for Injection 0.13 g+250 mL 0.9%sodium chloride injection for injection on the basis of the control group.Both groups were treated for two weeks.The therapeutic effects,ADL scores,NIHSS scores,changes of vascular endothelial function and inflammatory factors,and adverse reactions were compared between the two groups before and after treatment.Results After treatment,the total effective rate of the treatment group(92.31%)was higher than that of the control group(71.79%).After treatment,the serum hs-CRP,TNFalpha and IL-1 beta levels of the two groups were lower than those before treatment,and the treatment group was lower than that of the control group(P<0.05).The plasma ET-1 level was decreased and the plasma NO level was increased,and the improvement of treatment group was better than that of control group(P<0.05);ADL score and NIHSS score were improved in both groups after treatment,and the improvement of treatment group was better than that of control group(P<0.05).There were no obvious adverse reactions in both groups.Conclusion Salvianolic Acids for Injection combined with alteplase has a good effect on acute cerebral infarction patients,which can improve vascular endothelial dysfunction and alleviate inflammation,and have important research significance.