静脉溶栓桥接TREVO支架取栓对颈动脉T型闭塞脑梗死患者神经功能与炎性因子的影响

Effects of intravenous thrombolysis bridging TREVO stent to remove embolism on nerve function and inflammatory factors in patients with carotid artery T-occlusion cerebral infarction

目的研究静脉溶栓桥接TREVO支架取栓治疗颈动脉T型闭塞脑梗死患者的临床效果。方法按照随机数字表法将青岛市黄岛区人民医院2019年1月至2020年12月收治的50例颈动脉T型闭塞脑梗死患者分为对照组(25例)和观察组(25例)。对照组患者采用常规静脉溶栓治疗,观察组患者采用静脉溶栓桥接TREVO支架取栓治疗。比较两组患者治疗后血管再通率,治疗前、治疗后24 h美国国立卫生研究院卒中量表(NIHSS)评分,治疗后90 d的改良Rankin量表(mRS)评分,以及治疗前、治疗后24 h可溶性细胞间黏附分子-1(sICAM-1)、超敏-C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平。结果观察组患者的血管再通率为64.00%,高于对照组的36.00%;两组患者治疗后24 h NIHSS评分、治疗后90 d mRS评分及治疗后24 h血清sICAM-1、hs-CRP、TNF-α水平较治疗前降低,且观察组低于对照组(均P<0.05)。结论以静脉溶栓桥接TREVO支架取栓治疗颈动脉T型闭塞脑梗死患者,可有效提高患者的血管再通率,减轻患者炎症反应,改善神经功能,提高治疗效果。

Objective To study the clinical effect of intravenous thrombolysis and bridging TREVO stent for thrombus removal in patients with carotid artery T-occlusion cerebral infarction.Methods According to the random number table,50 patients with carotid artery T-occlusion cerebral infarction admitted to Huangdao District People's Hospital of Qingdao from January 2019 to December 2020 were divided into the control group(25 cases)and the observation group(25 cases).Patients in the control group were treated with conventional intravenous thrombolysis,and patients in the observation group were treated with intravenous thrombolysis bridging the TREVO stent.The recanalization rates of the two groups of patients after treatment were compared,the National Institutes of Health Stroke Scale(NIHSS)scores before and 24 h after treatment were compared,the modified Rankin amount Table(mRS)score before and 90 days after treatment were compared,the levels of soluble intercellular adhesion molecule-1(sICAM-1),high-sensitivity C reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α)24 h after treatment were compared.Results The recanalization rate of patients in the observation group was 64.00%,which was higher than 36.00%in the control group;the NIHSS score 24 h after treatment,mRS score 90 d after treatment and serum sICAM-1,hs-CRP and TNF-αlevels 24 h after treatment in the two groups were lower than those before treatment,and the observation group were lower than the control group(all P<0.05).Conclusion Intravenous thrombolysis bridging the TREVO stent for thrombus removal in patients with carotid artery T-occlusion cerebral infarction can effectively improve the patient's vascular recanalization rate,reduce the patient's inflammatory response,improve nerve function,and improve the treatment effect.