机械介入取栓术联合重组组织型纤溶酶原激活剂溶栓治疗对急性脑梗死患者血清因子水平及神经功能的影响研究

Effects of mechanical interventional thrombectomy combined with rt-PA thrombolysis on serum hs-CRP,NSE and neurological function in patients with acute cerebral infarction

目的探讨机械介入取栓术联合重组组织型纤溶酶原激活剂(rt-PA)溶栓治疗对急性脑梗死患者血清超敏C反应对白(hs-CRP)、神经元特异性烯醇化酶(NSE)水平及神经功能的影响。方法选择我院于2020年1月至2021年10月期间收治的186例急性脑梗死患者为研究对象,随机分为2组,各包括93例患者,对照组患者的治疗方法选择阿替普酶静脉溶栓,观察组加用机械介入取栓术。比较2组治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数(BI)评分及血清hs-CRP、NSE水平的变化,以及临床疗效。结果2组治疗后,NIHSS评分明显降低、BI评分升高,且观察组明显优于对照组(P<0.05);观察组治疗总有效率为88.2%,明显高于对照组的77.3%,差异有统计学意义(P<0.05);治疗后,血清hs-CRP及NSE水平在2组均有明显下降,且观察组与对照组比较更低(P<0.05)。结论急性脑梗死选择机械介入取栓术联合rt-PA溶栓治疗,可明显降低血清hs-CRP、NSE水平,对神经功能改善有利。

Objective To investigate the effects of mechanical interventional thrombectomy combined with recombinant tissue plasminogen activator(rt-PA)thrombolysis on serum high-sensitivity C-reactive protein(hs-CRP),neuron specific enolase(NSE)and neurological function in patients with acute cerebral infarction.Methods One hundred and eighty-six cases of patients with acute cerebral infarction treated in our hospital from January 2020 to October 2021 were randomly divided into two groups,including 93 patients in each group.The patients in the control group received intravenous thrombolysis with alteplase,and the observation group was further treated with mechanical intervention.The changes of national institutes of health stroke scale(NIHSS)score,Barthel index(BI)score,serum hs-CRP and NSE levels between the two groups before and after treatment and clinical efficacy were compared.Results After treatment,NIHSS score decreased significantly and BI score increased significantly in both groups and compared control group,the observation group was better significantly(P<0.05).In the observation group,the total effective rate(88.2%)was significantly higher than the control group(77.3%)(P<0.05).After treatment,in both groups,the hs-CRP and NSE were significantly lower and compared control group,they were significantly lower in the observation group(P<0.05).Conclusion Mechanical interventional thrombectomy combined with rt-PA thrombolysis in the treatment of acute cerebral infarction can effectively reduce the levels of serum hs-CRP and NSE and improve neurological function.