阿替普酶联合羟乙基淀粉治疗缺血性脑卒中的疗效分析

Effect analysis of alteplase combined with hydroxyethyl starch in the treatment of ischemic stroke

目的探讨缺血性脑卒中患者采用羟乙基淀粉与阿替普酶联合治疗的临床价值。方法246例缺血性脑卒中患者,随机分为对照组和观察组,每组123例。两组均进行常规治疗,对照组给予阿替普酶治疗,观察组在对照组基础上运用羟乙基淀粉联合治疗。比较两组治疗效果、治疗前后美国国立卫生研究院卒中量表(NIHSS)评分及血清学指标。结果治疗后3、7、14 d,观察组NIHSS评分分别为(15.09±3.45)、(4.12±1.78)、(2.01±0.44)分,均明显低于对照组的(17.68±5.34)、(9.11±3.09)、(4.56±2.11)分,差异有统计学意义(P<0.05)。观察组治疗总有效率91.06%高于对照组的73.17%,差异有统计学意义(P<0.05)。治疗后,观察组可溶性肿瘤坏死因子相关性凋亡诱导配体(sTRAIL)和骨保护素(OPG)水平分别为(67.23±10.09)、(108.23±34.23)ng/L,均明显低于对照组的(92.09±15.67)、(143.25±27.56)ng/L,差异有统计学意义(P<0.05)。结论临床运用羟乙基淀粉联合阿替普酶治疗缺血性脑卒中患者,能够减轻神经功能损伤,促进治疗效果的提高,值得推广。

Objective To discuss the clinical value of alteplase combined with hydroxyethyl starch in the treatment of ischemic stroke.Methods A total of 246 patients with ischemic stroke were randomly divided into control group and observation group,with 123 cases in each group.Both groups received conventional treatment.On this basis,the control group was treated with alteplase,and the observation group was treated with hydroxyethyl starch on the basis of the control group.The therapeutic effect,and National Institutes of Health Stroke Scale(NIHSS)score and serological indexes before and after treatment were compared between the two groups.Results On 3,7 and 14 d after treatment,NIHSS scores in the observation group were(15.09±3.45),(4.12±1.78)and(2.01±0.44)points,which were significantly lower than those of(17.68±5.34),(9.11±3.09)and(4.56±2.11)points in the control group,and the differences were statistically significant(P<0.05).The total effective rate of the observation group was 91.06%,which was higher than that of 73.17%of the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of soluble tumor necrosis factorrelated apoptosis-inducing ligand(sTRAIL)and osteoprotetin(OPG)in the observation group were(67.23±10.09)ng/L and(108.23±34.23)ng/L,which were significantly lower than those of(92.09±15.67)and(143.25±27.56)ng/L in the control group,and the differences were statistically significant(P<0.05).Conclusion The clinical application of hydroxyethyl starch combined with alteplase in the treatment of patients with ischemic stroke can reduce neurological damage and promote the improvement of therapeutic effect,which is worth promoting.