舒血宁注射液联合重组组织型纤溶酶原激活剂静脉溶栓治疗急性缺血性脑卒中疗效及对血清脂蛋白相关磷脂酶A2、同型半胱氨酸、高敏C反应蛋白水平的影响

The curative efficacy of shuxuening injection combined with rt-PA intravenous thrombolysis in the treatment of acute ischemic stroke and its effects on levels of serum Lp-PLA2,HCY,and hsCRP

目的探讨舒血宁注射液联合重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗急性缺血性脑卒中(AIS)疗效及对血清脂蛋白相关磷脂酶A2(Lp-PLA2)、同型半胱氨酸(HCY)、高敏C反应蛋白(hsCRP)水平的影响。方法我院收治的86例AIS患者,简单随机化分为对照组和观察组各43例,对照组接受rt-PA静脉溶栓治疗及其他基础治疗,观察组在对照组基础上加用舒血宁注射液治疗,比较两组疗效、神经功能、血液流变学指标及血清Lp-PLA2、HCY、hsCRP水平,进行安全性评价。结果对照组和观察组治疗总有效率分别为72.09%和90.70%,差异有统计学意义(P<0.05);治疗14天内,两组NIHSS评分逐渐降低,且观察组治疗7天及14天的NIHSS评分均低于对照组(P<0.05);治疗后,两组血液流变学指标(全血黏度高切值和低切值、血浆黏度、血小板聚集率、红细胞压积)水平和血清Lp-PLA2、HCY、hsCRP水平较治疗前均降低,且观察组低于对照组(P<0.05);两组治疗期间均未出现明显药物不良反应。结论舒血宁注射液联合rt-PA静脉溶栓治疗急性缺血性脑卒中疗效确切,有利于改善患者血液流变学指标和下调Lp-PLA2、HCY、hsCRP水平,从而促进患者神经功能的恢复。

Objective To explore the efficacy of shuxuening injection combined with recombinant tissue plasminogen activator(rt-PA)intravenous thrombolysis in the treatment of acute ischemic stroke(AIS)and its effects on levels of serum lipoprotein-related phospholipase A2(Lp-PLA2),homocysteine(HCY),and high sensitivity C-reactive protein(hsCRP).Methods Eighty-six AIS patients admitted to our hospital were selected and divided into control or observation group by simple randomized grouping,43 in each group.The control group received rt-PA intravenous thrombolysis and other basic treatments,and the observation group was additionally given shuxuening injection on the basis of control group.The efficacy,neurological function,hemorheology indexes and serum Lp-PLA2,HCY,and hsCRP were compared between the two groups,and the safety was evaluated.Results After treatment,the total effective rates of treatment in the control group and the observation group were 72.09%and 90.70%,respectively(P<0.05).Within 14 days of treatment,National Institutes of Health Neurological Impairment Scale(NIHSS)score in the two groups showed a decreasing trend,and the NIHSS scores in the observation group after 7 and 14 days of treatment were lower than those in the control group(P<0.05).After treatment,the levels of hemorheology indexes such as high-shear and low-shear viscosity of whole blood,plasma viscosity,platelet aggregation rate and hematocrit as well as serum Lp-PLA2,HCY,and hsCRP in the two groups were lower than those before treatment,and the levels in the observation group were lower than those in the control group(P<0.05).There were no obvious adverse drug reactions in the two groups during treatment.Conclusion Shuxuening injection combined with rt-PA intravenous thrombolysis has a definite efficacy in the treatment of acute ischemic stroke.It is beneficial to improve the hemorheology indexes and down-regulate the levels of Lp-PLA2,HCY,and hsCRP,thereby promoting the recovery of neurological function.