急性缺血性脑卒中血管内介入治疗效果及对IGF-1、HCY、Lp-PLA2的影响

Effect of intravascular interventional therapy and its influences on IGF-1,HCY and LpPLA2 in acute ischemic stroke

目的分析急性缺血性脑卒中(AIS)血管内介入治疗效果及对胰岛素样生长因子-1(IGF-1)、同型半胱氨酸(HCY)、血清脂蛋白相关磷脂酶A2(Lp-PLA2)的影响。方法选取自2020年3月—2022年5月唐山市丰润区人民医院收治的203例AIS患者的临床资料,根据治疗方法不同将其分为观察组(血管内介入治疗,n=108)和对照组(药物静脉溶栓治疗,n=95)。比较两组患者临床疗效、神经功能恢复情况[美国国立卫生院神经功能缺损量表(NIHSS)],分析两组治疗前、后血液流变学指标(红细胞压积、血小板聚集率、血浆粘度、全血低切黏度、全血高切黏度)及血清IGF-1、HCY、Lp-PLA2水平变化情况。结果观察组治疗总有效率(87.96%)明显高于对照组(73.68%),差异具有统计学意义(P<0.05)。治疗后观察组各时间点NIHSS评分低于对照组,差异有统计学意义(P<0.05)。治疗后观察组红细胞压积水平、血小板聚集率、血浆黏度、全血黏度低切值和高切值均低于对照组,差异有统计学意义(P<0.05)。治疗后观察组HCY、Lp-PLA2水平均低于对照组,IGF-1高于对照组,差异有统计学意义(P<0.05)。结论血管内介入治疗AIS疗效确切,有利于改善AIS患者神经功能缺损症状、血液流变学相关指标及IGF-1、HCY、Lp-PLA2水平,促进患者早日康复。

Objective To analyze the treatment effect of intravascular interventional therapy and its influences on insulin-like growth factor-1(IGF-1),homocysteine(HCY)and serum lipoprotein-associated phospholipase A2(Lp-PLA2)in acute ischemic stroke(AIS).Methods The clinical data of 203 patients with AIS admitted to Tangshan Fengrun District People's Hospital from March 2020 to May 2022 were selected,and according to different treatment methods,they were divided into the observation group(intravascular intervention therapy,n=108)and the control group(intravenous thrombolysis therapy,n=95).The clinical efficacy,neurological function recovery[National Institutes of Health Neurological Deficit Scale(NIHSS)]were compared between the two groups,the hemorheological indexes(hematocrit,platelet aggregation rate,plasma viscosity,whole blood low tangential viscosity,whole blood high tangential viscosity)and serum IGF-1,HCY and Lp-PLA2 levels were analyzed before and after treatment between the two groups.Results The total effective rate in the observation group(87.96%)was significantly higher than that in the control group(73.68%),and the difference was statistically significant(P<0.05).After treatment,the NIHSS scores in the observation group were lower than those in the control group at each time point,and the difference was statistically significant(P<0.05).After treatment,the hematocrit level,platelet aggregation rate,plasma viscosity,low and high cut values of whole blood viscosity in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the HCY and LpPLA2 levels in the observation group were lower than those in the control group,while IGF-1 levels in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).Conclusion Intravascular interventional therapy for AIS is effective,and it is beneficial to improve the neurological deficit symptoms,hemorheological indicators,and the levels of IGF-1,HCY and Lp-PLA2 in AIS patients,and promote the early recovery of patients.