阿替普酶联合丹参多酚酸治疗急性脑梗死的效果

Efficacy of alteplase combined with salvianolic acids on acute cerebral infarction

目的探讨阿替普酶联合丹参多酚酸治疗急性脑梗死的效果。方法抽取南阳市中心医院2017年3月至2020年3月收治的100例急性脑梗死患者为研究对象,采用随机数字表法将纳入患者分为对照组与研究组,每组50例。两组均给予常规对症治疗,对照组给予阿替普酶溶栓,研究组患者给予阿替普酶联合丹参多酚酸治疗。比较两组治疗效果、神经功能缺损状况、生活能力、脑灌注参数及不良反应发生情况。结果研究组治疗总有效率为96.00%(48/50),高于对照组的76.00%(38/50),P<0.05。治疗后,两组美国国立卫生研究院卒中量表(NIHSS)评分较治疗前降低,Barthel指数评分较治疗前升高(P<0.05),且研究组治疗后NIHSS评分低于对照组,Barthel指数评分高于对照组(P<0.05)。治疗后,两组患者脑灌注参数(脑血流量、脑血容量)均较治疗前增加(P<0.05),脑血流平均通过时间、达峰时间较治疗前降低(P<0.05);且研究组治疗后脑血容量、脑血流量水平高于对照组(P<0.05),脑血流平均通过时间、达峰时间低于对照组(P<0.05)。两组治疗期间不良反应发生情况比较差异未见统计学意义(P>0.05)。结论阿替普酶联合丹参多酚酸治疗急性脑梗死疗效显著且安全可靠,可有效提高患者脑血灌注量,从而改善患者神经功能缺损状况并提高生活能力。

Objective To investigate the efficacy of alteplase combined with salvianolic acids on acute cerebral infarction.Methods A total of 100 patients with acute cerebral infarction treated in Nanyang Central Hospital from March 2017 to March 2020 were selected as research objects.And they were divided into control group and study group by random number table method,with 50 cases in each group.All patients were given conventional symptomatic treatment.The control group was given alteplase for thrombolysis,and the study group was given alteplase combined with salvianolic acids for treatment.The efficacy,neurological deficit status,living ability,cerebral perfusion parameters and adverse reactions were compared between the two groups.Results The total effective rate of study group was 96.00%(48/50),significantly higher than 76.00%(38/50)in control group(P<0.05).After treatment,the National Institute of Health stroke scale(NIHSS)score of the two groups was significantly reduced(P<0.05),while the Barthel index score was significantly increased,compared with those before treatment(P<0.05);and the postoperative NIHSS score of study group was significantly lower than that of control group(P<0.05),while the postoperative Barthel index score was significantly higher than that in control group(P<0.05).The levels of cerebral perfusion parameters(cerebral blood volume,cerebral blood flow)in the two groups were significantly increased,compared with those before treatment(P<0.05);after treatment,the mean transit time of cerebral blood flow and time to peak of the two groups were significantly decreased,compared with those before treatment(P<0.05).After treatment,the levels of cerebral blood flow and cerebral blood volume in study group were higher than those in control group(P<0.05),while the levels of mean transit time of cerebral blood flow and time to peak were significantly lower than those in control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusions Alteplase combined with salvianolic acids has significant efficacy,and it is safe and reliable in the treatment of acute cerebral infarction.It can effectively improve cerebral blood perfusion,thereby improving the neurological deficit status and enhancing the living ability.