尿激酶静脉溶栓治疗联合介入治疗中重度脑梗死患者的疗效研究

Effect of Urokinase Intravenous Thrombolysis Combined with Interventional Therapy in the Treatment of Patients with Moderate and Severe Cerebral Infarction

背景溶栓、介入治疗是现阶段临床治疗中重度脑梗死的有效手段,但关于两者联合在中重度脑梗死治疗中的研究报道并不多见。目的分析尿激酶静脉溶栓治疗联合介入治疗中重度脑梗死患者的疗效。方法选取2016年8月—2018年10月武汉市普仁医院收治的中重度脑梗死患者91例,根据抽签法分为对照组(n=45)和观察组(n=46)。对照组患者采用介入治疗,观察组患者采用尿激酶静脉溶栓治疗联合介入治疗。比较两组患者临床疗效,治疗前、治疗后1个月美国国立卫生研究院卒中量表(NIHSS)评分、基质金属蛋白酶9(MMP-9)、血管内皮生长因子(VEGF),观察治疗1个月内两组患者死亡情况及再发脑梗死、症状性脑出血、非症状性脑出血发生情况。结果观察组患者临床疗效优于对照组(P<0.05)。治疗前两组患者NIHSS评分比较,差异无统计学意义(P>0.05);治疗后1个月观察组患者NIHSS评分低于对照组(P<0.05)。两组患者治疗前MMP-9、VEGF比较,差异无统计学意义(P>0.05);观察组患者治疗后1个月MMP-9、VEGF低于对照组(P<0.05)。治疗1个月,两组患者死亡率、症状性脑出血发生率比较,差异无统计学意义(P>0.05);观察组患者再发脑梗死、非症状性脑出血发生率低于对照组(P<0.05)。结论与介入治疗比较,尿激酶静脉溶栓治疗联合介入治疗中重度脑梗死患者的临床疗效确切,可有效改善患者的神经功能,缓解患者病情,且安全性高。

Background Thrombolysis therapy and interventional therapy are effective means for clinical treatment of moderate and severe cerebral infarction at present,but there are few research reports on the combination of the two in the treatment of moderate and severe cerebral infarction.Objective To analyze the effect of urokinase intravenous thrombolysis combined with interventional therapy in the treatment of patients with moderate and severe cerebral infarction.Methods 91 patients with moderate and severe cerebral infarction in Wuhan Puren Hospital from August 2016 to October 2018 were selected,they were divided into control group(n=45)and observation group(n=46)according to the method of drawing lots.Patients in control group were treated with interventional therapy,and patients in observation group were treated with urokinase intravenous thrombolysis combined with interventional therapy.The clinical effects,NIHSS score,matrix metalloproteinase 9(MMP-9)and vascular endothelial growth factor(VEGF)before and 1 month after treatment between the two groups were compared.The incidence of death,recurrent cerebral infarction,symptomatic cerebral hemorrhage and non-symptomatic cerebral hemorrhage was observed between the two groups 1 month after treatment.Results The clinical effect in observation group was better than that in control group(P<0.05).There was no statistically significant difference in NIHSS score between the two groups before treatment(P>0.05);NIHSS score in observation group was lower than that in control group 1 month after treatment(P<0.05).There was no statistically significant difference in MMP-9 and VEGF between the two groups before treatment(P>0.05);MMP-9 and VEGF in observation group were lower than those in control group 1 month after treatment(P<0.05).There was no statistically significant difference in incidence of death and symptomatic intracerebral hemorrhage between the two groups 1 month after treatment(P>0.05).The incidence of recurrent cerebral infarction and asymptomatic cerebral hemorrhage in observation group were lower than those in control group 1 month after treatment(P<0.05).Conclusion Compared with interventional therapy,urokinase intravenous thrombolysis combined with interventional therapy has a definite clinical effect in patients with moderate and severe cerebral infarction,can effectively improve the patients'neurological function,alleviate the condition,with high safety.