急性缺血性脑卒中患者应用依达拉奉右莰醇联合重组组织型纤溶酶原激活剂溶栓的效果观察

Observation on the effect ofedaravone-dexborneol combined with rt-PA thrombolysis in patients with acute ischemic stroke

目的分析急性缺血性脑卒中(AIS)患者应用依达拉奉右莰醇(ED)联合重组组织型纤溶酶原激活剂(rt-PA)溶栓的临床效果。方法2019年3月至2022年3月我院收治的94例AIS患者,按照随机数字表法分为对照组与观察组各47例,对照组接受rt-PA治疗,观察组在对照组基础上加以ED治疗。治疗14 d后比较两组临床疗效、超声指标、脑血流灌注情况及并发症。结果观察组临床有效率93.62%显著高于对照组76.60%(P<0.05);治疗后两组颈动脉内膜中层厚度(IMT)、颈动脉粥样硬化斑块总面积(TPA)及斑块不稳定数目均显著降低(P<0.05),且观察组较对照组更低(P<0.05);两组收缩期峰值流速(PSV)、TMV均显著升高,阻力指数(RI)显著降低(P<0.05),且观察组较对照组PSV、TMV更高,RI更低(P<0.05);观察组出血性转化(HT)发生率低于对照组(P<0.05)。结论ED联合rt-PA溶栓治疗AIS中可协同增效,改善患者动脉粥样情况,提高脑血流灌注,降低出血性转化发生率。

bolysis in patients with acute ischemic stroke(AIS).Methods A total of 94 patients with AIS who were treated in our hospital from March 2019 to March 2022 were selected.The patients were divided into an observation group and a control group according to random number table method,47 in each group.The control group was treated with rt-PA,while the observation group was treated with ED combined with rt-PA.Clinical efficacy,ultrasonic parameters,cerebral blood perfusion and complications were compared between the two groups.Results The response rate in the observation group was 93.62%,that was significantly higher than 76.60%in the control group(P<0.05).After treatment,intima-media thickness(IMT),total plaque area(TPA)and unstable plaques in both groups were decreased significantly(P<0.05),and the decreases were more significant in the observation group(P<0.05).After treatment,peak systolic velocity(PSV)and mean velocity(TMV)were increased significantly and resistance index(RI)was decreased significantly in both groups and the increases and the decrease in the observation group were greater than those in the control group(P<0.05).The incidence of hemorrhagic transformation(HT)in the observation group was significantly lower than that in the control group(P<0.05).Conclusions ED combined with rt-PA thrombolysis in the treatment of AIS can be synergistic in the treatment of AIS.It can improve the atherosclerosis and increase the cerebral blood perfusion.It also reduces the incidence of hemorrhagic transformation.