Solitaire AB型支架机械取栓术联合静脉溶栓治疗前循环急性缺血性脑卒中的疗效

Effect of Solitaire AB stent mechanical embolectomy combined with intravenous thrombolysis for acute ischemic stroke in anterior circulation

目的分析Solitaire AB支架介入治疗缺血性脑卒中患者的临床疗效及其对神经功能、免疫功能的影响。方法纳入2020-07—2022-06中国人民解放军联勤保障部队第九〇二医院收治的68例缺血性脑卒中患者,对照组和观察组各34例。对照组患者采用阿替普酶静脉溶栓治疗,观察组患者在对照组的基础上联合Solitaire AB支架介入取栓治疗,随访观察3个月。比较2组患者的临床疗效、治疗前后神经功能评分与神经保护因子水平、免疫功能指标及并发症发生情况。结果观察组临床总有效率高于对照组(94.12%对76.47%,P<0.05),随访时的IGF-1、BDNF、CD4^(+)、CD4^(+)/CD8^(+)高于对照组(P<0.05),NIHSS评分、GFAP、CD8^(+)水平低于对照组(P<0.05)。2组患者的并发症发生率比较(11.76%对17.65%),差异无统计学意义(P>0.05)。结论Solitaire AB支架介入治疗缺血性脑卒中可显著改善患者的神经和免疫功能,疗效更加理想,安全性高。

Objective To analyze the clinical efficacy of Solitaire AB stent intervention in ischemic stroke and its effect on neurological and immune function.Methods From July 2020 to June 2022,68 patients with ischemic stroke admitted to the 902nd Hospital of China People’s Liberation Army Joint Logistic Support Force were selected as the study subjects,and they were divided into control group(34 patients)and observation group(34 patients).The control group was treated with intravenous thrombolysis with alteplase,the observation group used Solitaire AB stent based on the control group and was followed up for 3 months.The difference between the clinical efficacy,neurological function scores and the level of neuroprotective factors,immune function indicators,and the occurrence of complications were compared between the two groups.Results The observation group had a higher clinical response rate than the control group(94.12%vs 76.47%,P<0.05),IGF-1,BDNF,CD4^(+),CD4^(+)/CD8^(+)were higher(P<0.05),and NIHSS score,GFAP,CD8^(+)levels were lower than the control group(P<0.05).Comparison of the complication rates between the two patient groups(11.76%vs 17.65%),there was no statistical significance(P>0.05).Conclusion Solitaire AB stent intervention for ischemic stroke can significantly improve the neurological and immune function of patients,with more ideal efficacy and high safety.