阿替普酶静脉溶栓治疗急性缺血性脑卒中的临床研究

Clinical Research of Intravenous Thrombolysis with Alteplase in Treating the Acute Ischemic Stroke

目的探讨阿替普酶静脉溶栓治疗急性缺血性脑卒中(AIS)的临床效果。方法选择2020年12月-2022年6月在本院就诊的80例AIS患者的临床资料,所有患者均给予静脉溶栓治疗,按照随机摸红蓝球法分为两组,各40例,其中对照组给予尿激酶治疗,研究组给予阿替普酶治疗,比较两组治疗前后Barthel指数(BI)、美国国立卫生研究院卒中量表(NIHSS)评分、生活质量和实验室指标[同型半胱氨酸(Hcy)、超敏-C反应蛋白(hs-CRP)]水平的差异。统计两组预后情况及不良反应发生率。结果治疗前两组hs-CRP、Hcy评分比较无明显差异(P>0.05);治疗后两组hs-CRP、Hcy均低于治疗前(P<0.05)。治疗后研究组hs-CRP、Hcy水平均低于对照组(P<0.05)。治疗后组内BI指数、NIHSS评分和生活质量评分优于治疗前,治疗后研究组BI指数和生活质量评分均高于对照组,NIHSS评分低于对照组(P<0.05)。两组不良反应总发生率比较无明显差异(P>0.05)。结论阿替普酶静脉溶栓治疗急性缺血性脑卒中可获得理想的治疗效果,有助于改善患者的神经功能及炎症指标,促进预后恢复。

Objective To discuss the clinical effects of intravenous thrombolysis with alteplase in treating the acute ischemic stroke(AIS).Methods General data about 80 AIS patients of undergoing the intravenous thrombolysis(2020.12-2022.6)was analyzed.According to random number table,patients were assigned to control group(n=40,urokinase)and study group(n=40,alteplase).Group contrast results were obtained through the Barthel index(BI),national institute of health stroke scale(NIHSS)and life quality scores,laboratory index like homocysteine(Hcy)and hypersensitivity C-reactive protein(hs-CRP),treatment prognosis and adverse reactions.Results Before treatment,there were no significant between-group differences about hs-CRP and Hcy contents(P>0.05);after treatment,hs-CRP and Hcy contents for two groups were lower than before(P<0.05);after treatment,hs-CRP and Hcy contents in the study group were even lower than control group(P<0.05);before treatment,there were no significant between-group differences about BI,NIHSS and life quality scores(P>0.05);after treatment,BI and life quality scores for two groups were higher than before;NIHSS scores for two groups were lower than before(P<0.05);after treatment,BI and life quality scores in the study group were even higher than control group;NIHSS scores in the study group were even lower than control group(P<0.05);the total adverse drug rate between groups was not significantly different(P>0.05).Conclusion The intravenous thrombolysis with alteplase can reduce the inflammatory factors,and improve the neurological function and treatment prognosis for acute ischemic stroke patients.