阿替普酶静脉溶栓治疗急性轻型缺血性脑卒中的疗效及对患者神经功能的影响

Effect of alteplase intravenous thrombolytic therapy on acute mild ischemic stroke and its effect on neurological function

目的探讨阿替普酶静脉溶栓治疗急性轻型缺血性脑卒中的的疗效及对患者神经功能的影响。方法选取2019年4月至2020年11月本院收治的110例急性轻型缺血性脑卒中患者作为研究对象,按照随机数字表法分为对照组与对照组,每组55例。对照组采用常规双抗治疗,观察组采用阿替普酶静脉溶栓,比较两组卒中评分[美国国立卫生研究院卒中量表(NIHSS)]、生活能力[Barthel指数(BI)]、炎症指标[白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、超敏C-反应蛋白(hs-CRP)]。结果两组NIHSS评分组间、时间、交互比较差异有统计学意义(P<0.05)。组内比较:治疗后1、3个月,两组NIHSS评分均低于治疗前,差异有统计学意义(P<0.05);治疗后3个月,两组NIHSS评分均低于治疗后1个月,差异有统计学意义(P<0.05)。组间比较:治疗前,两组NIHSS评分比较差异无统计学意义;治疗后1、3个月,观察组NIHSS评分低于对照组,差异有统计学意义(P<0.05)。两组BI评分组间、时间、交互比较差异有统计学意义(P<0.05)。组内比较:治疗后1、3个月,两组BI评分均高于治疗前差异有统计学意义(P<0.05);治疗后3个月,两组BI评分均高于治疗后1个月,差异有统计学意义(P<0.05)。组间比较:治疗前,两组BI评分比较差异无统计学意义;治疗后1、3个月,观察组BI评分高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组IL-6、TNF-α、hs-CRP水平均低于对照组,差异有统计学意义(P<0.05)。结论阿替普酶静脉溶栓急性轻型脑卒中患者效果显著,有效缓解炎症反应,修复神经功能,提升生命质量,值得临床推广应用。

Objective To investigate the effect of alteplase intravenous thrombolytic therapy on acute mild ischemic stroke and its effect on neurological function.Methods 110 patients with acute mild ischemic stroke admitted to our hospital from April 2019 to November 2020 were selected as the research subjects,and they were divided into control group and control group according to random number table method,with 55 cases in each group.The control group was treated with conventional double antibodies,and the observation group was treated with alteplase intravenous thrombolysis,the stroke score(National Institutes of Health stroke scale[NIHSS]),living ability(Barthel index[BI]),inflammatory indexes(interleukin-6[IL-6]),tumor necrosis factor-α[TNF-α],high-sensitivity C-reactive protein[hs-CRP]were compared between the two groups.Results There were significant differences in NIHSS scores between the two groups of inter-group,time and interaction(P<0.05).Intra-group comparison:at 1 and 3 months after treatment,the NIHSS scores of the two groups were lower than those before treatment,and the differences were statistically significant(P<0.05);at 3 months after treatment,the NIHSS scores of the two groups were lower than those at 1 month after treatment,and the difference was statistically significant(P<0.05).Comparison between groups:before treatment,there was no significant difference in NIHSS score between the two groups;at 1 and 3 months after treatment,NIHSS score of observation group was lower than control group,the difference was statistically significant(P<0.05).There were significant differences in the BI scores between the two groups of inter-group,time and interaction(P<0.05).Intra-group comparison:at 1 month and 3 months after treatment,the BI scores of the two groups were higher than those before treatment,and the differences were statistically significant(P<0.05);at 3 months after treatment,the BI scores of the two groups were higher than those after 1 month of treatment,and the difference was statistically significant(P<0.05).Comparison between groups:before treatment,there was no significant difference in BI scores between the two groups;at 1 and 3 months after treatment,the BI scores of observation group was higher than control group,the difference was statistically significant(P<0.05).After treatment,the levels of IL-6,TNF-αand hs-CRP in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Alteplase intravenous thrombolysis has significant effect on patients with acute mild stroke,which can effectively relieve inflammatory reaction,repair nerve function,and improve the quality of life,which is worthy of clinical application.