丁苯酞联合阿替普酶治疗急性缺血性脑卒中的效果分析

Effects of butylphthalide combined with alteplase on acute ischemic stroke

目的分析丁苯酞联合阿替普酶治疗急性缺血性脑卒中(AIS)的效果。方法前瞻性选取聊城市第二人民医院2020年11月至2021年10月收治的AIS患者176例作为观察对象,按照患者住院顺序编号分为对照组和联合组,每组88例。对照组给予阿替普酶静脉溶栓;联合组在给予阿替普酶治疗6 h后静脉滴注丁苯酞氯化钠注射液,两组均连续治疗2周。比较两组美国国立卫生研究院卒中量表(NIHSS)评分、临床疗效,比较两组血清白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、高敏C反应蛋白(hs-CRP)水平差异性以及观察期间的药物不良反应发生率。结果溶栓后,联合组患者的NIHSS评分[(4.23±1.75)分]、血清IL-6[(6.42±2.05)ng/L]、TNF-α[(13.42±3.59)ng/L]、hs-CRP[(3.17±0.94)mg/L]水平均显著低于对照组[(7.28±1.93)分、(9.58±2.79)ng/L、(22.28±3.73)ng/L、(5.23±1.25)mg/L)](t=10.98、20.29、16.06、12.36,均P<0.001)。联合组总有效率[94.32%(83/88)]显著高于对照组[80.68%(71/88)](χ^(2)=7.48,P<0.05)。联合组药物不良反应发生率[6.82%(6/88)]和对照组[11.36%(10/88)]比较,差异无统计学意义(χ^(2)=0.01,P>0.05)。结论丁苯酞联合常规溶栓药物阿替普酶早期治疗AIS可提高治疗效果,改善神经功能,减轻炎症反应。在急性缺血性脑卒中早期应用该联合药物方案具有积极的临床价值。

Objective To analyze the effects of butylphthalide combined with alteplase on acute ischemic stroke.Methods A total of 176 patients with acute ischemic stroke who received treatment at The Second People's Hospital of Liaocheng from November 2020 to October 2021 were prospectively included in this study.They were divided into control and combined treatment groups(n=88/group)according to hospital registraction number.The control group was given intravenous thrombolysis with alteplase.The combined treatment group was intravenously administered alteplase for 6 hours followed by butylphthalide sodium chloride injection.The two groups were treated for 2 consecutive weeks.The National Institutes of Health Stroke Scale score,clinical efficacy,interleukin-6,tumor necrosis factor-α,and high-sensitivity C-reactive protein levels as well as the incidence of adverse drug reactions were compared between the two groups.Results After thrombolysis,the National Institutes of Health Stroke Scale score,interleukin-6,tumor necrosis factor-α,and high-sensitivity C-reactive protein levels in the combined treatment group were(4.23±1.75)points,(6.42±2.05)ng/L,(13.42±3.59)ng/L,and(3.17±0.94)mg/L,respectively,which were significantly lower than(7.28±1.93)points,(9.58±2.79)ng/L,(22.28±3.73)ng/L,and(5.23±1.25)mg/L,respectively in the control group(t=10.98,20.29,16.06,12.36,all P<0.001).The total response rate in the combined treatment group was significantly higher than that in the control group[94.32%(83/88)vs.80.68%(71/88),χ^(2)=7.48,P<0.05].There was no significant difference in the incidence of adverse drug reactions between the combined treatment and control groups[6.82%(6/88)vs.11.36%(10/88),χ^(2)=0.01,P>0.05].Conclusion Butylphthalide combined with alteplase for the early treatment of acute ischemic stroke can increase therapeutic efficacy,improve neurological function,and reduce inflammatory responses.The combined therapy has a positive clinical value in the early treatment of acute ischemic stroke.