观察阿替普酶静脉溶栓治疗对不同病因新发脑梗死患者预后的影响

To observe the effect of intravenous thrombolytic therapy with alteplase on the prognosis of patients with new cerebral infarction of different etiologies

目的探讨阿替普酶静脉溶栓治疗对不同病因新发脑梗死患者预后的影响。方法选取2018年9月至2020年9月本院收治的96例新发脑梗死患者为研究对象,随机分为对照组和观察组,各48例。对照组予以常规(非溶栓)治疗,观察组采用阿替普酶静脉溶栓治疗,比较两组治疗前后脑血流超声参数、神经功能(NIHSS)及不良反应发生率。结果治疗前,两组脑血流超声参数比较差异无统计学意义;治疗后,观察组Vs、Vd指标均高于对照组(P<0.05)。治疗前,两组神经功能比较差异无统计学意义;治疗后,观察组S100-β、GFAP、MBP均低于对照组,NSE指数高于对照组(P<0.05)。治疗后,观察组不良反应发生率为14.58%,低于对照组的58.33%(P<0.05)。结论采用阿替普酶静脉溶栓应用于不同病因新发脑梗死患者的临床治疗中,可有效加强患者脑部血流速率,缓解脑部神经损伤情况,降低不良反应发生率,获得良好的治疗预后,值得临床推广应用。

Objective To investigate the effect of intravenous thrombolysis therapy with alteplase on the prognosis of patients with new cerebral infarction of different etiologies.Methods A total of 96 patients with new cerebral infarction admitted to our hospital from September 2018 to September 2020 were selected as the research subjects,and they were randomly divided into control group and observation group,with 48 cases in each group.The control group received conventional(non-thrombolytic)treatment,and the observation group received intravenous thrombolysis with alteplase.The comparison of cerebral blood flow ultrasound parameters,neurological function(NIHSS)before and after treatment,and the adverse reactions were compared between the two groups.Results Before treatment,there was no significant difference in the ultrasound parameters of cerebral blood flow between the two groups.After treatment,the Vs and Vd indexes of the observation group were higher than those of the control group(P<0.05).Before treatment,there was no statistically significant difference in neurological function between the two groups;after treatment,S100-β,GFAP,and MBP in the observation group were lower than those in the control group;the NSE index was higher than that in the control group(P<0.05).After treatment,The adverse reaction rate in the observation group was 14.58%,which was lower than 58.33%in the control group(P<0.05).Conclusion The application of intravenous thrombolysis with alteplase in the clinical treatment of patients with new cerebral infarctions of different causes can effectively enhance the blood flow rate of the brain,alleviate brain nerve damage,reduce the incidence of adverse reaction,and obtain good treatment,it is worthy of clinical application.