西洛他唑在急性脑梗死患者rt-PA溶栓治疗后的作用及对血清CD62p、CD63、PAF的作用分析

Effect of Cilostazol after rt-PA Thrombolytic Therapy in Patients with Acute Cerebral Infarction and Its Effect on Serum CD62p,CD63 and PAF

目的:探讨西洛他唑在急性脑梗死患者重组人组织型纤溶酶原激活物(rt-PA)溶栓治疗后的作用及对血清血小板溶酶体膜蛋白(CD63)、α颗粒膜糖蛋白(CD62p)、血小板活化因子(PAF)的作用分析。方法:选择2020年2月至2022年2月我院接诊的90例急性脑梗死患者,按照随机数表法分为观察组及对照组,各45例。两组均接受rt-PA溶栓治疗,对照组溶栓后使用阿司匹林治疗,观察组在对照组基础上,联合西洛他唑治疗,均连续治疗14 d。比较两组临床疗效、血清CD62p、CD63、PAF、全血粘度、血浆粘度和红细胞比容(HCT)及美国国立卫生院卒中量表(NIHSS)评分、巴氏量表(Barthel指数)评分的变化及出血事件发生率。结果:观察组患者的临床疗效总有效率为91.11%,高于对照组的73.33%,有统计学意义(P<0.05);观察组血清CD62p、CD63、PAF均比对照组低,有统计学意义(P<0.05);观察组全血粘度、血浆粘度、HCT均比对照组低,有统计学意义(P<0.05);观察组的NIHSS评分均低于对照组,Barthel指数高于对照组,有统计学意义(P<0.05);两组出血事件总发生率比较,无统计学意义(P>0.05)。结论:西洛他唑在急性脑梗死患者rt-PA溶栓治疗后的作用明显,可有效降低血清CD62p、CD63、PAF的表达,改善血小板功能,安全性较好,值得临床推广。

Objective:To study the effect of cilostazol after thrombolytic therapy with recombinant human tissue plasminogen activator(rt-PA)in patients with acute cerebral infarction and its effect on Serum Platelet lysosomal membrane protein(CD63),αRole of granule membrane glycoprotein(CD62P)and platelet activating factor(PAF).Methods:90 patients with acute cerebral infarction treated in our hospital from February 2020 to February 2022,they were randomly divided into observation group and control group,with 45 cases in each group.Both groups were treated with rt-PA thrombolytic therapy,the control group was treated with aspirin after thrombolytic therapy,and the observation group was treated with cilostazol on the basis of the control group,and were treated continuously for 14 days.The clinical efficacy,changes of serum CD62p,CD63,PAF,whole blood viscosity,plasma viscosity,erythrocyte specific volume(HCT),NIHSS score,Barthel scale(Barthel Index)score,and incidence of bleeding events were compared between the two groups.Results:The total effective rate of the observation group was 91.11%,which was higher than 73.33%of the control group,with statistical significance(P<0.05);the serum CD62p,CD63 and PAF in observation group were lower than those in control group,with statistical significance(P<0.05);the whole blood viscosity,plasma viscosity and HCT in observation group were lower than those of control group,with statistical significance(P<0.05);the NIHSS score in observation group was lower than control group,and Barthel index was higher than control group,with statistical significance(P<0.05);comparison of the total incidence of bleeding events between the two groups,with statistical significance(P>0.05).Conclusion:Cilostazol have a significant effect on acute cerebral infarction patients after rt-PA thrombolytic therapy,which can effectively reduce the expression of serum CD62p,CD63 and PAF and improve platelet function,with good safety and worthy of clinical promotion.