阿替普酶对急性缺血性卒中患者的疗效及血清炎性因子的影响

The efficacy of alteplase in the treatment of acute ischemic stroke and its effect on serum inflammatory factors

目的观察阿替普酶治疗急性缺血性卒中的疗效评估和对血清炎性因子的影响。方法选择2020年1月至2021年1月牡丹江医学院附属红旗医院住院治疗的在发病6 h内的急性缺血性卒中患者120例为研究对象,根据入院后给予的治疗方案将患者分为对照组和实验组(各60例),对照组给予常规治疗方案(药物保守治疗),实验组给予常规治疗+阿替普酶治疗,总疗程为14 d。收集所有受试者入院的临床资料,包括年龄、性别、发病时间;入院及治疗14 d的NIHSS评分、Barthel评分、GQOL-74量表评分;采用酶联免疫吸附试验法(ELISA)检测和两组患者治疗前后白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素(IL-10)、肿瘤坏死因子α(TNF-α)、超敏C反应蛋白(hs-CRP)水平。分析两组患者NIHSS评分和Barthel评分、血清炎性因子、生活质量、治疗有效率的组间差异。结果实验组患者治疗有效率高于对照组(P<0.05);两组患者炎性因子水平存在显著差异(P<0.05),实验组患者IL-6、IL-8、TNF-α、hs-CRP指标均低于对照组,实验组患者IL-10指标高于对照组;治疗前后两组患者生活质量对比存在显著差异(P<0.05),实验组患者语言能力、自理能力、心理状态、社会领域、家庭领域评分高于对照组;治疗前后两组患者NIHSS评分和Barthel评分存在显著差异(P<0.05);实验组患者NIHSS评分低于对照组,Barthel评分高于对照组(P<0.05)。结论阿替普酶治疗急性缺血性卒中可获得显著疗效;阿替普酶治疗急性缺血性卒中可降低患者体内血清炎性因子水平。

Objective To observe the efficacy of alteplase in the treatment of acute ischemic stroke and its effect on serum inflammatory factors.Methods A total of 120 patients with acute ischemic stroke within 6 hours,who were admitted to the Hongqi Hospital affiliated to Mudanjiang Medical College from January 2020 to January 2021,were included as subjects in this study.All patients were randomly selected as the subjects and divided into control and experimental groups according to the treatment regimen given after admission(60 patients in each group).The control group was given the conventional treatment regimen(conservative treatment with drugs)and the experimental group was given conventional treatment combined with alteplase for a total duration of 14 days.The clinical data of all subjects admitted to the hospital were collected,mainly including age,sex and time of onset.The NIHSS score,Barthel score and GQOL-74 scale after admission and 14 days of treatment were also collected.The enzyme-linked immunosorbent assay(ELISA)was used to detect and compare interleukin-6(IL-6),interleukin-8(IL-8),interleukin(IL-10),tumor necrosis factor-α(TNF-α),tumor necrosis factor-α(TNF-α),and ultrasensitive C-reactive protein(hs)before and after treatment in both groups.The intergroup differences in NIHSS score and Barthel score,serum inflammatory factors,quality of life,and treatment efficiency were analyzed in the two groups.Results The treatment efficiency of the experimental group was higher than that of the control group before and after treatment(P<0.05).There were significant differences in the levels of inflammatory factors between the two groups(P<0.05),the indexes of IL-6,IL-8,TNF-αand hs-CRP were lower in the experimental group than those in the control group,and the index of IL-10 was higher in the experimental group than that in the control group.There were significant differences in the quality of life between the two groups before and after treatment(P<0.05),and the scores of language ability,self-care ability,psychological status,social domain and family domain were higher in the experimental group than those in the control group.There were significant differences in the NIHSS scores and Barthel scores between the two groups before and after treatment(P<0.05),and the NIHSS scores were lower in the experimental group than that in the control group,and the Barthel scores were higher in the experimental group than that in the control group.Barthel scores in the experimental group were higher than those in the control group.Conclusion The application of alteplase for acute ischemic stroke results in significant therapeutic effects.The application of alteplase for acute ischemic stroke has a lower effect on serum inflammatory factor levels in patients.