丁苯酞联合阿替普酶治疗缺血性卒中患者的效果

Effects of Butylphthalide combined with Alteplase in treatment of patients with ischemic stroke

目的:观察丁苯酞联合阿替普酶治疗缺血性卒中患者的效果。方法:回顾性分析2020年1月至2022年1月该院收治的80例缺血性卒中患者的临床资料,按照治疗方法不同将其分为对照组和观察组各40例。两组均进行常规治疗,在此基础上,对照组采用阿替普酶静脉溶栓治疗,观察组在对照组基础上联合丁苯酞治疗,比较两组临床疗效,治疗前后灌注参数[脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)、达峰时间(TTP)]水平、神经功能缺损[美国国立卫生研究院卒中量表(NIHSS)]评分、日常生活活动能力[Barthel指数(BI)]评分、认知功能[蒙特利尔认知评估量表(MoCA)]评分,以及不良反应发生率。结果:治疗后,观察组CBV、CBF水平和BI、MoCA评分均高于对照组,MTT、TTP水平和NIHSS评分均低于对照组,差异有统计学意义(P<0.05);观察组治疗总有效率为97.50%(39/40),高于对照组的70.00%(28/40),差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:丁苯酞联合阿替普酶治疗缺血性卒中患者可改善灌注参数水平,降低神经功能缺损评分,提高治疗总有效率、BI评分和MoCA评分,效果优于单纯阿替普酶治疗。

Objective:To observe effects of Butylphthalide combined with Alteplase in treatment of patients with ischemic stroke.Methods:The clinical data of 80 patients with ischemic stroke admitted to this hospital from January 2020 to January 2022 were retrospectively analyzed.They were divided into control group and observation group according to different treatment methods,40 cases in each.Both groups received routine treatment.On this basis,the control group was treated with Alteplase intravenous thrombolysis,while the observation group was treated with Butylphthalide on the basis of that of the control group.The clinical efficacy,the perfusion parameter levels[cerebral blood flow(CBF),cerebral blood volume(CBV),mean transit time(MTT),time to peak(TTP)]before and after the treatment,the neurological deficit[national institutes of health stroke scale(NIHSS)]score,the ability to perform activities of daily living[Barthel Index(BI)]score,the cognitive function[Montreal cognitive assessment scale(MoCA)]score,and the incidence of adverse reactions were compared between the two groups.Results:After the treatment,the CBV and CBF levels as well as the BI and MoCA scores of the observation group were higher than those of the control group,the MTT and TTP levels and the NIHSS score were lower than those of the control group,and the differences were statistically significant(P<0.05).The total effective rate of treatment in the observation group was 97.50%(39/40),which was higher than 70.00%(28/40)in the control group,and the difference was statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Butylphthalide combined with Alteplase in the treatment of the patients with ischemic stroke can improve the levels of perfusion parameters,reduce the neurological deficit scores,and improve the total effective rate,the BI score and the MoCA score.Moreover,it is superior to single rt-PA treatment.