醒脑静联合阿替普酶对急性缺血性脑卒中患者的影响

Effect of Xingnaojing combined with alteplase on patients with acute ischemic stroke

目的探讨醒脑静联合阿替普酶治疗急性缺血性脑卒中(AIS)的临床效果及对颅内血流状况的影响。方法选取2017年1月至2019年12月于本院就诊的80例AIS患者,按随机数字表法分为两组,各40例。对照组男29例,女11例,年龄(62.39±4.15)岁;观察组男27例,女13例,年龄(62.43±4.17)岁。对照组予以阿替普酶治疗,观察组加用醒脑静治疗。比较两组颅内血流速度、神经功能和不良反应发生情况。结果治疗前,两组急性缺血性脑卒中患者颅内血流速度比较,差异均无统计学意义(均P>0.05);治疗后,观察组基底动脉、椎动脉、大脑前动脉、大脑中动脉、大脑后动脉血流速度分别为(39.87±4.48)cm/s、(36.43±4.18)cm/s、(45.96±5.01)cm/s、(44.68±4.57)cm/s、(43.25±4.23)cm/s,均高于对照组(34.53±4.26)cm/s、(32.15±4.07)cm/s、(42.33±4.85)cm/s、(41.36±4.32)cm/s、(39.16±4.14)cm/s,差异均有统计学意义(均P<0.05)。治疗前,两组急性缺血性脑卒中患者神经功能比较,差异无统计学意义(P>0.05);两组治疗后神经功能评分均较治疗前降低,且观察组低于对照组,差异均有统计学意义(均P<0.05)。对照组不良反应发生率为7.50%(3/40),与观察组10.00%(4/40)比较,差异无统计学意义(P>0.05)。结论醒脑静联合阿替普酶可改善AIS患者颅内血流速度,增加脑部血液灌注,减轻神经功能损伤,安全可靠。

Objective To investigate the clinical effect of Xingnaojing combined with alteplase in the treatment of acute ischemic stroke(AIS)and its influence on intracranial blood flow.Methods A total of 80 AIS patients in our hospital from January 2017 to December 2019 were selected and were divided into two groups according to the random number table method,with 40 cases in each group.In the control group,there were 29 males and 11 females,with an age of(62.39±4.15)years old;in the observation group,there were 27 males and 13 females,with an age of(62.43±4.17)years old.The control group was treated with alteplase,and the observation group was treated with Xingnaojing and alteplase.The intracranial blood flow velocity,nerve function,and occurrence of adverse reactions were compared between the two groups.Results Before the treatment,there were no statistically significant differences in the intracranial blood flow velocities between the two groups(all P>0.05);after the treatment,the blood flow velocities of basilar artery,vertebral artery,anterior cerebral artery,middle cerebral artery,and posterior cerebral artery in the observation group were(39.87±4.48)cm/s,(36.43±4.18)cm/s,(45.96±5.01)cm/s,(44.68±4.57)cm/s,and(43.25±4.23)cm/s,which were higher than those in the control group[(34.53±4.26)cm/s,(32.15±4.07)cm/s,(42.33±4.85)cm/s,(41.36±4.32)cm/s,and(39.16±4.14)cm/s],with statistically significant differences(all P<0.05).Before the treatment,there was no statistically significant difference in the nerve function between the two groups(P>0.05);after the treatment,the nerve function scores in both groups were lower than those before the treatment,and that in the observation group was even lower,with statistically significant differences(all P<0.05).The incidence of adverse reactions was 7.50%(3/40)in the control group and 10.00%(4/40)in the observation group,without statistically significant difference(P>0.05).Conclusion Xingnaojing combined with alteplase can improve the intracranial blood flow velocity in patients with AIS,increase the cerebral blood perfusion,reduce the nerve function damage,and is safe and reliable.