阿替普酶早期静脉溶栓治疗急性脑梗死的临床疗效

Clinical efficacy of intravenous thrombolytic therapy with arteprase in patients with acute cerebral infarction

目的探讨阿替普酶早期(发病3.0~4.5小时)静脉溶栓治疗急性脑梗死患者的临床疗效。方法120例急性脑梗死患者根据不同治疗方法分为常规治疗组53例和阿替普酶溶栓组67例,常规治疗组给予常规治疗,阿替普酶溶栓组给予阿替普酶静脉溶栓治疗,比较两组治疗前后的神经功能(NIHSS评分、mRS评分)、氧化应激反应(SOD、GSH-px与MDA)、炎性因子水平(IL-1β、TNF-α、hs-CRP、MDA)和日常生活活动能力(ADL评分)。结果两组在治疗过程中均未出现严重不良反应。与常规治疗组比较,治疗后阿替普酶溶栓组NIHSS评分和mRS评分明显较低(P<0.05);SOD、GSH-px水平明显较高、MDA水平明显降低(P<0.05);IL-1β、TNF-α、hs-CRP水平明显降低(P<0.05);ADL评分明显提高(P<0.05)。结论急性脑梗死早期采用阿替普酶静脉溶栓治疗可以明显改善神经功能,减轻氧化应激和炎症反应,提高日常生活活动能力,是一种安全有效的方法。

Objective To investigate the clinical effect of early intravenous thrombolysis with alteplase(3~4.5 hours after onset)on patients with acute cerebral infarction.Methods 120 patients with acute cerebral infarction were divided into routine treatment group(53 cases)and Ateplase thrombolysis group(67 cases)according to different treatment methods.The routine treatment group was given routine treatment,and the Ateplase thrombolysis group was given intravenous thrombolysis with alteplase.The neurological function(NIHSS、Mrs),oxidative stress response(SOD、GSH-PX、MDA),and inflammatory factor level(IL-1)were compared between the two groups before and after treatment(IL-1β、TNF-α、hs-CRP、MDA)and activities of daily living(ADL).Results There were no serious adverse reactions in both groups.Compared with the routine treatment group,the NIHSS score and Mrs score of the Ateplase thrombolysis group were significantly lower after treatment(P<0.05);The levels of SOD and GSH PX were significantly higher than those of MDA(P<0.05);IL-1β、TNF-α、The level of hs-CRP decreased significantly(P<0.05);ADL score was significantly improved(P<0.05).Conclusion Intravenous thrombolysis with ateplase in the early stage of acute cerebral infarction can significantly improve neurological function,reduce oxidative stress and inflammatory reaction,and improve the ability of daily living.It is a safe and effective method.