己酮可可碱联合阿替普酶静脉溶栓对急性脑梗死患者NIHSS、MMSE评分及血清Lp-PLA2、NLR水平的影响观察

Effects of Pentoxifylline Combined with Alteplase Intravenous Thrombolysis on the Scores of NIHSS and MMSE and Serum Levels of Lp-PLA2 and NLR in Patients with Acute Cerebral Infarction

目的:观察己酮可可碱联合阿替普酶静脉溶栓对急性脑梗死(ACI)患者的美国国立卫生研究院卒中量表(NIHSS)评分、简易智能精神状态检查量表评分(MMSE)及血清脂蛋白相关磷脂酶A2(Lp-PLA2)、中性粒细胞淋巴细胞计数比值(NLR)水平的影响。方法:82例ACI患者随机分为观察组(n=41)与对照组(n=41)。对照组予阿替普酶静脉溶栓治疗,观察组在对照组基础上加用己酮可可碱治疗,疗程均为2周。比较两组患者治疗后的临床疗效、不良反应,以及NIHSS评分、MMSE评分,血清Lp-PLA2、NLR水平变化。结果:观察组治疗总有效率高于对照组(P<0.05)。治疗后,两组NIHSS评分、血清Lp-PLA2、NLR水平均较治疗前下降,MMSE评分较治疗前增加(P<0.05);且观察组各项指标均优于对照组(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论:己酮可可碱联合阿替普酶静脉溶栓治疗ACI疗效较好,能改善患者神经功能和认知功能,下调血清Lp-PLA2、NLR水平,且安全性较好。

Objective:To investigate the effects of pentoxifylline combined with alteplase intravenous thrombolysis on the National Institutes of Health Stroke Scale(NIHSS)score,Mini Mental State Examination scale(MMSE)score,serum lipoprotein associated phospholipase A2(Lp-PLA2)and neutrophil to lymphocyte count(NLR)in patients with acute cerebral infarction(ACI).Methods:Eighty-two ACI patients in our hospital from January 2019 to January 2021 were enrolled,and divided into two groups by random number table method with 41 cases in each.Control group received alteplase intravenous thrombolytic therapy,while observation group received rt-PA thrombolytic therapy combined with pentoxifylline.Treatment in both groups lasted for two weeks.The clinical outcomes,adverse reaction rates,scores of NIHSS and MMSE,and serum levels of Lp-PLA2 and NLR were compared between the groups.Results:The total effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the NIHSS score,Lp-PLA2 and NLR of the two groups decreased and the MMSE score increased(P<0.05),and the NIHSS score,Lp-PLA2 and NLR of the observation group were lower than those of the control group,and the MMSE score was higher than that of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Application of pentoxifylline combined with alteplase intravenous thrombolysis is an effective and safe treatment plan for ACI patients,which can effectively ameliorate the neurological function and cognitive function,and downregulate serum levels of Lp-PLA2 and NLR.