西洛他唑对急性缺血性脑卒中患者溶栓后的治疗效果及血清PAF、vWF水平的影响

Effect of cilostazol in the treatment of patients with acute ischemic stroke after thrombolytic therapy and its effect on serum platelet activating factor and von willebrand factor levels

目的 探讨西洛他唑对急性缺血性脑卒中患者溶栓后的治疗效果,并观察其对血清血小板活化因子(PAF)、血管性血友病因子(vWF)水平的影响。方法 选择2019年5月至2022年5月西安宝石花长庆医院收治的102例急性缺血性脑卒中患者进行前瞻性研究,按照随机数表法分为观察组和对照组各51例。两组患者均接受阿替普酶溶栓治疗,对照组患者溶栓后使用阿司匹林治疗,观察组患者在对照组基础上联合西洛他唑治疗,两组均连续治疗2周。比较两组患者治疗2周后的临床疗效和治疗前后血清PAF、vWF、红细胞比容(HCT)、纤维蛋白原(FIB)水平及美国国立卫生院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分、日常生活能力(Brathel指数)的变化,并比较两组患者治疗期间出血事件发生情况。结果 治疗后,观察组患者临床疗效总有效率为90.20%,明显高于对照组的72.55%,差异有统计学意义(P<0.05);治疗后,观察组患者的血清PAF、vWF、HCT、FIB分别为(70.23±6.94) ng/L、(98.06±14.21)μg/L、(0.40±0.07)%、(3.48±0.63) g/L,明显低于对照组的(81.04±8.37) ng/L、(117.83±17.39)μg/L、(0.48±0.09)%、(4.02±0.71) g/L,差异均有统计学意义(P<0.05);治疗后,观察组患者的NIHSS评分、m RS评分分别为(7.35±1.35)分、(1.82±0.28)分,明显低于对照组的(9.08±1.42)分、(2.24±0.35)分,Barthel指数为(70.03±7.41)分,明显高于对照组的(62.16±6.28)分,差异均有统计学意义(P<0.05);观察组患者治疗期间的出血事件总发生率为11.76%,略高于对照组的9.80%,但差异无统计学意义(P>0.05)。结论 西洛他唑在急性缺血性脑卒中患者溶栓后的应用可有效降低患者的血清PAF、vWF水平,改善神经功能,临床治疗效果显著。

Objective To explore the therapeutic effect of cilostazol in the treatment of patients with acute isch-emic stroke after thrombolysis,and observe its effect on serum platelet activating factor(PAF)and von willebrand factor(vWF)levels.Methods A total of 102 patients with acute ischemic stroke admitted to Xi'an Baoshihua Changqing Hos-pital from May 2019 to May 2022 were selected for this prospective study.The patients were divided into an observation group and a control group according to the random number table method,with 51 patients in each group.Based on thrombolytic therapy with alteplase,patients in the control group were treated with aspirin after thrombolytic therapy,while those in the observation group were treated with cilostazol on the basis of the control group,both for 2 weeks.The clinical efficacy at 2 weeks after treatment and the changes of serum PAF,vWF,hematocrit(HCT),fibrinogen(FIB),Na-tional Institutes of Health Stroke Scale(NIHSS)score,modified Rankin scale(mRS)score,and Brathel index before and 2 weeks after treatment were compared between the two groups.The incidence of bleeding events during treatment were compared between the two groups.Results After treatment,the total effective rate in the observation group was 90.20%,which was significantly higher than 72.55%in the control group(P<0.05).After treatment,the serum PAF,vWF,HCT,FIB in the observation group were(70.23±6.94)ng/L,(98.06±14.21)μg/L,(0.40±0.07)%,(3.48±0.63)g/L,which were significantly lower than(81.04±8.37)ng/L,(117.83±17.39)μg/L,(0.48±0.09)%,(4.02±0.71)g/L in the con-trol group(P<0.05).After treatment,the NIHSS score and mRS score in the observation group were(7.35±1.35)points and(1.82±0.28)points,which were significantly lower than(9.08±1.42)points and(2.24±0.35)points in the control group;the Barthel index was(70.03±7.41)points,which was significantly higher than(62.16±6.28)points in the control group;the differences were statistically significant(P<0.05).The total incidence of bleeding events during treatment in the observation group was slightly higher than that in the control group(11.76%vs 9.80%),but the difference was not sta-tistically significant(P>0.05).Conclusion The application of cilostazol after thrombolysis in patients with acute isch-emic stroke can effectively reduce the serum PAF and vWF levels and improve neurological function recovery,with sig-nificant clinical treatment effect,which is worthy of clinical promotion.