阿替普酶联合尤瑞克林治疗老年急性脑梗死患者的临床效果及对血清Fibulin-5、NO、S100B表达的影响

Clinical Effect of Alteplase Combined with Urinary Kallidinogenase on Elderly Patients with Acute Cerebral Infarction and Its Influence on the Expression of Serum Fibulin-5,NO and S100B

目的:探讨阿替普酶联合尤瑞克林治疗老年急性脑梗死(ACI)患者的临床效果。方法:将福建医科大学附属三明第一医院2020年8月—2022年8月接诊的99例老年ACI患者按照随机数字表法分为联合组(n=52)和对照组(n=47)。所有患者均予以常规对症治疗,对照组予以尤瑞克林治疗,联合组予以阿替普酶联合尤瑞克林治疗。对比两组治疗效果,血清扣针蛋白5(Fibulin-5)、一氧化氮(NO)、S100B蛋白、可溶性凋亡相关因子配体(sFasL)、可溶性凋亡相关因子(sFas)、B淋巴细胞瘤-2(Bcl-2)水平,简易精神状态检查(MMSE)评分和美国国立卫生研究院卒中量表(NIHSS)评分,以及安全性。结果:联合组总有效率高于对照组(90.38%vs.74.47%)(P<0.05);治疗2周后,两组血清Fibulin-5、NO、S100B、sFasL、sFas及Bcl-2水平均有所改善,且联合组均优于对照组(P<0.05);治疗2周后,联合组MMSE评分高于对照组,而NIHSS评分低于对照组(P<0.05);联合组和对照组不良反应总发生率比较,差异有统计学意义(7.69%vs.25.53%)(P<0.05)。结论:老年ACI患者选择阿替普酶联合尤瑞克林治疗效果确切,可能与改善血清Fibulin-5、NO、S100B水平及细胞凋亡因子水平有关,可提高生活质量和日常生活能力,安全性高。

Objective:To investigate the clinical effect of Alteplase combined with Urinary Kallidinogenase in the treatment of elderly patients with acute cerebral infarction(ACI).Method:A total of 90 elderly ACI patients admitted to the First Affiliated Sanming Hospital of Fujian Medical University from August 2020 to August 2022 were divided into a combination group(n=52)and a control group(n=47)according to random number table method.All patients were treated with conventional symptomatic treatment,the control group was treated with Urinary Kallidinogenase,and the combination group was treated with Alteplase combined with Urinary Kallidinogenase.Therapeutic effect,the levels of serum Fibulin-5(Fibulin-5),nitric oxide(NO),S100B protein,soluble apoptosis-related factor ligand(sFasL),soluble apoptosis-related factor(sFas),B cell lymphoma-2(Bcl-2)and mini mental status examination(MMSE)scores and national institute of health stroke scale(NIHSS)scores and safety were compared between the two groups.Result:The total effective rate of combination group was higher than that of control group(90.38%vs.74.47%)(P<0.05).After 2 weeks of treatment,serum Fibulin-5,NO,S100B,sFasL,sFas and Bcl-2 levels in both groups were improved,and those in the combination group were better than those in the control group(P<0.05).After 2 weeks of treatment,MMSE score in combination group was higher than that in control group,NIHSS score in combination group was lower than that in control group(P<0.05).There was significant difference in the total incidence of adverse reactions between the combination group group and the control group(7.69%vs.25.53%)(P<0.05).Conclusion:Alteplase combined with Urinary Kallidinogenase has a definite therapeutic effect in elderly ACI patients,which may be related to improving the levels of serum Fibulin-5,NO,S100B and apoptosis factors,and can improve the quality of life and daily living ability,with high safety.