尤瑞克林联合阿替普酶溶栓治疗急性脑梗死的效果分析

Analysis of the effect of urinary kallidinogenase combined with alteplase thrombolysis in the therapy of acute cerebral infarction

目的探讨尤瑞克林联合阿替普酶治疗急性脑梗死的效果。方法50例急性脑梗死患者,依据随机数字表法分为对照组与观察组,每组25例。对照组应用阿替普酶静脉溶栓治疗,观察组在对照组基础上联合应用尤瑞克林治疗。比较两组美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分、血清炎性因子[C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-8(IL-8)]、血流动力学指标[最大峰值流速(Vs)、平均流速(Vm)、舒张末流速(Vd)、血管搏动指数(PI)以及血管阻力指数(RI)]、不良反应发生率。结果治疗后2周、3个月,观察组患者的NIHSS评分与mRS评分均低于对照组,差异有统计学意义(P<0.05)。治疗后1周,观察组CRP、PCT、IL-8水平分别为(7.25±2.35)mg/L、(0.62±0.34)ng/ml、(25.41±4.16)ng/L,均低于对照组的(12.25±2.34)mg/L、(0.86±0.41)ng/ml、(30.26±5.32)ng/L,差异有统计学意义(P<0.05)。治疗后1周,观察组患者Vs(54.21±3.15)cm/s、Vd(27.62±2.52)cm/s、Vm(30.24±2.15)cm/s、PI(0.85±0.24)均高于对照组的(50.16±2.35)cm/s、(24.15±2.30)cm/s、(27.26±3.52)cm/s、(0.70±0.20),RI(0.64±0.20)低于对照组的(0.80±0.23),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)。结论采用尤瑞克林联合阿替普酶静脉溶栓治疗急性脑梗死患者,与单一用药对比在功能恢复、减轻炎症方面有优势,且不增加不良反应。

Objective To discuss the effect of urinary kallidinogenase combined with alteplase thrombolysis in the therapy of acute cerebral infarction.Methods A total of 50 patients with acute cerebral infarction were divided into control group and observation group according to random numerical table,with 25 cases in each group.The control group was given intravenous thrombolysis with alteplase,and the observation group was combined with urinary kallidinogenase on the basis of the control group.Both groups were compared in terms of National Institutes of Health Stroke Scale(NIHSS)score,modified Rankin Scale(mRS)score,serum inflammatory factors[C-reactive protein(CRP),procalcitonin(PCT),interleukin-8(IL-8)],hemodynamic indexes[peak flow velocity(Vs),mean flow velocity(Vm),end-diastolic flow velocity(Vd),pulsation index(PI)],resistance index(RI),and incidence of adverse reactions.Results 2 weeks and 3 months after treatment,NIHSS score and mRS score in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).1 week after treatment,the levels of CRP,PCT and IL-8 were(7.25±2.35)mg/L,(0.62±0.34)ng/ml and(25.41±4.16)ng/L in the observation group,which were lower than those of(12.25±2.34)mg/L,(0.86±0.41)ng/ml and(30.26±5.32)ng/L in the control group,and the differences were statistically significant(P<0.05).1 week after treatment,the levels of Vs,Vd,Vm and PI were(54.21±3.15)cm/s,(27.62±2.52)cm/s,(30.24±2.15)cm/s and(0.85±0.24)in the observation group,which were higher than those of(50.16±2.35)cm/s,(24.15±2.30)cm/s,(27.26±3.52)cm/s and(0.70±0.20)in the control group;RI of(0.64±0.20)in the observation group was lower than that of(0.80±0.23)in the control group;the differences were statistically significant(P<0.05).The difference was not statistically significant when comparing the incidence of adverse reactions between the two groups(P>0.05).Conclusion Urinary kallidinogenase combined with intravenous thrombolysis with ateplasein the treatment of patients with acute cerebral infarction has advantages in functional recovery,reducing inflammation,and does not increase adverse reactions compared with single drug therapy.