疏血通联合阿替普酶静脉溶栓治疗急性缺血性卒中患者的效果

Effects of Shuxuetong combined with Alteplase intravenous thrombolysis on patients with acute ischemic stroke

目的:观察疏血通联合阿替普酶静脉溶栓治疗急性缺血性卒中患者的效果。方法:选取2019年1月至2021年6月该院收治的122例急性缺血性卒中患者进行前瞻性研究,按照随机数字表法分为对照组和研究组各61例。对照组采取阿普替酶静脉溶栓治疗,研究组在对照组基础上联合疏血通治疗。比较两组临床疗效,治疗前和治疗48 h后神经功能缺损程度[美国国立卫生研究院卒中量表(NIHSS)]评分、预后[改良的Rankin量表(MRS)]评分、治疗前和治疗14 d后血清神经元特异性烯醇化酶(NSE)中枢神经特异性蛋白(S100-β)水平,以及不良反应发生率。结果:研究组治疗总有效率为96.72%,高于对照组的86.89%,差异有统计学意义(P<0.05);治疗后,两组NIHSS评分均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);治疗14 d后,研究组MRS评分为(2.11±0.18)分,低于对照组的(2.47±0.27)分,差异有统计学意义(P<0.05);治疗后,两组血清NSE和S100-β水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);研究组不良反应发生率为13.11%,低于对照组的29.51%,差异有统计学意义(P<0.05)。结论:疏血通联合阿替普酶静脉溶栓治疗急性缺血性卒中患者可提高治疗总有效率,降低NIHSS评分、MRS评分、NSE水平、S100-β水平和不良反应发生率,效果优于单纯阿替普酶静脉溶栓治疗。

Objective:To observe effects of Shuxuetong combined with Alteplase intravenous thrombolysis on patients with acute ischemic stroke.Methods:122 patients with acute ischemic stroke who were admitted to this hospital from January 2019 to June 2021 were selected for the prospective study.They were divided into control group and study group according to the random number table method,61 cases in each group.The control group received Alteplase intravenous thrombolysis,while the study group received Shuxuetong therapy on the basis of that of the control group.The clinical efficacy,the neurological deficit degree[national institutes of health stroke scale(NIHSS)]scores before and 48 hours after the treatment,the prognosis[modified Rankin scale(MRS)]score,the serum levels of neuron-specific enolase(NSE)and central nervous system-specific protein(S100-β)before and 14 days after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the study group was 96.72%,which was higher than 86.89%of the control group,and the difference was statistically significant(P<0.05).After the treatment,the NIHSS scores of the two groups were lower than those before the treatment,that of the study group was lower than that of the control group,and the difference was statistically significant(P<0.05).After 14 days of treatment,the MRS score of the study group was(2.11±0.18),which was lower than the control group of(2.47±0.27),and the difference was statistically significant(P<0.05).After the treatment,the levels of serum NSE and S100-βin the two groups were lower than those before the treatment,those of the study group were lower than those of the control group,and the differences were statistically significant(P<0.05).Further,the incidence of adverse reactions in the study group was 16.39%,which was lower than 29.51%in the control group,and the difference was statistically significant(P<0.05).Conclusions:Shuxuetong combined with Alteplase intravenous thrombolysis in the treatment of the acute ischemic stroke patients can improve the total effective rate of treatment,reduce the NIHSS score,the MRS score,the NSE level,the S100-βlevel and the incidence of adverse reactions.Moreover,it is superior to single Alteplase intravenous thrombolysis.