阿替普酶联合丁苯酞治疗老年急性脑梗死患者对血清Fibulin-5、NO、S100B表达影响与机制探讨

Exploring the Effects and Mechanisms of Serum Fibulin-5,NO,and S100B Expression in Elderly Patients with Acute Cerebral Infarction Treated with Alteplase Combined with Butylphthalide

目的分析阿替普酶联合丁苯酞治疗老年急性脑梗死患者对血清扣针蛋白、一氧化氮、S100B蛋白表达的影响,并探讨其机制。方法随机选择2019年12月—2020年12月龙岩市第二医院神经内科收治的100例急性脑梗死患者作为研究对象,以随机数表法均将患者分为观察组(n=50)和对照组(n=50)。对照组给予丁苯酞治疗,观察组采用丁苯酞联合阿替普酶治疗。比较两组治疗效果,记录治疗前后日常生活能力量表(ADL)评分、神经功能缺损(NIHSS)评分、Fibulin-5、NO、S100B及白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、C反应蛋白(CRP)水平变化,统计两组患者不良反应情况。结果观察组总有效率(94.00%)高于对照组(78.00%),差异有统计学意义(χ^(2)=5.316,P<0.05)。治疗后,两组ADL评分及Fibulin-5、NO水平均提高,而NIHSS评分及S100B水平均降低,但观察组治疗效果优于对照组,差异有统计学意义(P<0.05)。治疗后,两组IL-6、IL-8、CRP均降低,且观察组低于对照组,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)。结论阿替普酶联合丁苯酞治疗老年急性脑梗死可改善神经功能并提高日常生活能力,这可能与其可有效调控血清Fibulin-5、NO、S100B及炎症因子水平有关。

Objective To analyze the effect of Alteplase combined with Butylphthalide on the expression of serum Fibulin-5,nitric oxide,and S100B protein in elderly patients with acute cerebral infarction,and explore its mechanism.Methods 100 patients with acute cerebral infarction admitted to the Neurology Department of Longyan Second Hospital from December 2019 to December 2020 were randomly selected as the research subjects.The patients were randomly divided into an observation group(n=50)and a control group(n=50)using a random number table method.The control group was given Butylphthalide treatment and the observation group was treated with Butylphthalide combined with Alteplase.The treatment effects of the two groups were compared,and the changes of the ability of daily living scale(ADL)score,neurological deficit(NIHSS)score,Fibulin-5,NO,S100B and interleukin-6(IL-6),interleukin-8(IL-8)and C-reactive protein(CRP)levels were recorded before and after treatment,and the adverse reactions of patients in the two groups were counted.Results The total effective rate of the observation group(94.00%)was higher than that of the control group(78.00%),the difference was statistically significant(χ^(2)=5.316,P<0.05).After treatment,the ADL score,Fibulin-5,and NO levels of both groups increased,while the NIHSS score and S100B levels decreased,however,the treatment effect of the observation group was better than that of the control group,the difference was statistically significant(P<0.05).After treatment,the levels of IL-6,IL-8,and CRP in both groups decreased,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Alteplase combined with Butylphthalide in the treatment of senile acute cerebral infarction can improve neurological function and enhance the ability of daily living,which may be related to its effective regulation of serum levels of Fibulin-5,NO,S100B and inflammatory factors.