阿替普酶联合替米沙坦治疗对75例脑梗死患者炎症因子、血脂水平、神经功能、血液流变学的影响及疗效观察

Effects of alteplase thrombolysis combined with telmisartan on neurological function and hemorheology in patients with cerebral infarction

目的 探究阿替普酶联合替米沙坦治疗对脑梗死患者炎症因子、血脂水平、神经功能、血液流变学的影响及疗效观察。方法 选取2021年1月至2021年12月温岭市第一人民医院收治的150例脑梗死患者,采用随机数字表法分为对照组(n=75)和联合组(n=75),对照组给予替米沙坦进行治疗,联合组给予阿替普酶联合替米沙坦进行治疗,检测肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)、血管内皮生长因子(vascular endothelial growth factor,VEGF)、内皮素-1(endothelin,ET-1)水平和总胆固醇(total chorestrol,TC)、三酰甘油(triglycerides,TG)水平。采用美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评定患者神经功能,以Barthel指数评定患者日常生活能力。检测两组患者的血浆黏度(plasma viscosity,PV)、低切黏度(low blood viscosity,LBV)、高切黏度(high blood viscosity,HBV)水平和白细胞(white blood cell,WBC)计数水平,对两组治疗后效果进行比较。结果 治疗后,与对照组相比,联合组TNF-α、IL-6、TC、TG、ET-1、NIHSS评分、PV、LBV、HBV、WBC水平均显著降低(P<0.05);VEGF、Barthel指数水平显著升高(P<0.05)。结论 对脑梗死患者采用阿替普酶联合替米沙坦治疗,能够有效改善患者神经功能及血液流变学水平,减轻患者炎症反应,改善血脂、血管内皮功能、血常规水平,恢复日常生活能力,临床治疗效果显著。

Objective To explore the effects of alteplase thrombolysis combined with telmisartan on neurological function and hemorheology in patients with cerebral infarction. Methods A total of 150 patients who received cerebral infarction treatment in the First People’s Hospital of Wenling from January 2021 to December 2021 were selected and divided into the control group(n=75) and the combination group(n=75), according to the random number table method. The control group was treated with telmisartan, and the combined group was treated with alteplase thrombolysis combined with telmisartan. Detected the level of tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), vascular endothelial growth factor(VEGF), endothelin-1(ET-1) levels. The levels of total cholesterol(TC) and triglycerides(TG) were detected. Neurological function was assessed by National Institute of Health stroke scale(NIHSS) score. The Barthel index assessed patients’ ability of daily living, and detected plasma viscosity(PV), low shear viscosity(LBV), high shear viscosity(HBV) levels, and the level of white blood cell(WBC) count. The effects of the two groups after treatment were compared. Results After treatment, compared with the control group, the levels of TNF-α, IL-6, TC, TG, ET-1, NIHSS, PV, LBV, HBV, and WBC in the combined group were significantly decreased(P<0.05);VEGF and Barthel index level were significantly increased(P<0.05). Conclusion For patients with cerebral infarction, the combined regimen of alteplase thrombolysis and telmisartan can effectively improve the neurological function and blood rheology level of the patients, reduce the inflammatory response of the patients, and improve the blood lipids, vascular endothelial function and blood routine. level, restore the ability of daily living, and the clinical treatment effect is remarkable.