超早期脑梗死患者介入溶栓治疗的效果观察

Observation on the effects of interventional thrombolysis in patients with ultra-early cerebral infarction

目的 观察介入溶栓治疗超早期脑梗死患者的临床效果.方法 选取2017-06-2019-01南阳市中心医院超早期脑梗死患者82例,按照治疗方案不同分为研究组(n=41)和对照组(n=41).对照组采用静脉溶栓治疗,研究组采用动脉介入溶栓治疗.比较2组疗效 、并发症发生情况,以及治疗前 、治疗7 d后神经功能指标[血清星形胶质源性蛋白(S100B)、神经元特异性烯醇化酶(NSE)]、氧化应激指标[血清8-异前列腺素F2α(8-iso-PGF2α)、丙二醛(MDA)],治疗前与治疗14 d、28 d后美国国立卫生研究院卒中量表(NIHSS)评分.结果 研究组总有效率92.68%(38/41),高于对照组的75.61%(31/41)(P<0.05);治疗7 d后,2组血清S100B、NSE、8-iso-PGF2α 、MDA水平均降低,研究组低于对照组(P<0.05);治疗14 d、28 d后研究组NIHSS评分低于对照组(P<0.05);2组脑出血 、尿血 、皮肤黏膜出血 、黑便 、再闭塞发生率比较差异无统计学意义(P>0.05).结论 介入溶栓治疗超早期脑梗死,可通过调节机体神经功能损伤相关因子水平 、抑制机体氧化应激反应途径,改善患者神经功能损伤程度,疗效显著.

Objective To observe the clinical effect of interventional thrombolysis for patients with ultra early cerebral infarction.Methods From June 2017 to January 2019,82 patients with ultra early cerebral infarction in Nanyang Central Hospital were selected and divided into study group(n=41)and control group(n=41)according to different treatment schemes.The control group was treated with intravenous thrombolysis,and the study group was treated with arterial interventional thrombolysis.Compare the efficacy and complications of the two groups,as well as neurological indicators(serum astrogen derived protein(S100B),neuron specific enolase(NSE)),and oxidative stress indicators before and after 7 days of treatment(serum 8 isoprostaglandin F2α(8 iso PGF2α),malondialdehyde(MDA)),the National Institutes of Health Stroke Scale(NIHSS)score before and after 14 and 28 days of treatment.Results The total effective rate in the study group was 92.68%(38/41),which was higher than 75.61%(31/41)in the control group(P<0.05).After 7 days of treatment,serum S100B,NSE,8 iso PGF2α,MDA level decreased,and the study group was lower than the control group(P<0.05).After 14 days and 28 days of treatment,the NIHSS score of the study group was lower than the control group(P<0.05).There was no significant difference in the incidence of cerebral hemorrhage,hematuria,cutaneous mucous membrane bleeding,melena,and reocclusion in the two groups(P>0.05).Conclusion Interventional thrombolysis for the treatment of ultra early cerebral infarction can improve the degree of neurological damage in patients by regulating the level of neurological damage related factors and inhibiting the oxidative stress response of the body.