静脉溶栓桥接支架联合抽吸取栓术在颅内大血管急性闭塞中的疗效

Effect of Intravenous Thrombolysis Bridging Stent Combined with Aspiration Thrombectomy in Acute Occlusion of Intracranial Large Vessels

目的:探究静脉溶栓桥接支架联合抽吸取栓术在颅内大血管急性闭塞中的疗效及对神经凋亡的影响。方法:将2020年1月—2022年10月泉州德诚医院收治的80例颅内大血管急性闭塞患者根据随机数字表法分为对照组40例和观察组40例。对照组进行常规支架取栓术治疗,观察组则进行静脉溶栓桥接支架联合抽吸取栓术治疗。比较两组再通情况、取栓次数、再通时间、美国国立卫生院卒中量表(NIHSS评分)、血清神经损伤指标[神经元特异性烯醇化酶(NSE)、S-100钙结合蛋白β(S-100β)及脑源性神经营养因子(BDNF)]及血清神经凋亡指标[可溶性凋亡相关因子(sFas)及可溶性凋亡相关因子配体(sFasL)]。结果:观察组再通率显著高于对照组,取栓次数显著少于对照组,再通时间显著短于对照组,差异均有统计学意义(P<0.05)。治疗前,两组NIHSS评分情况、血清神经损伤指标及神经凋亡指标比较,差异均无统计学意义(P>0.05);治疗后48 h及14 d,观察组NIHSS评分情况均显著优于对照组,治疗后48 h及72 h,观察组血清BDNF均显著高于对照组,其他血清神经损伤指标及神经凋亡指标均显著低于对照组,差异均有统计学意义(P<0.05)。结论:静脉溶栓桥接支架联合抽吸取栓术在颅内大血管急性闭塞中的疗效较好,且可有效控制神经凋亡。

Objective:To investigate the effect of intravenous thrombolysis bridging stent combined with aspiration thrombectomy in acute occlusion of intracranial large vessels and influence for neuroptosis.Method:A total of 80 patients with acute occlusion of intracranial large vessels admitted to Quanzhou Decheng Hospital from January 2020 to October 2022 were divided into control group 40 cases and observation group 40 cases by random number table method.The control group was treated with conventional stent thrombectomy,the observation group was treated with intravenous thrombolysis bridging stent combined with aspiration thrombectomy.The revascularization situation,thrombectomy times,revascularization time,national institutes of health stroke scale(NIHSS)score,serum nerve injury indexes[neuron-specific enolase(NSE),S-100 calcium binding proteinβ(S-100β)and brain-derived neurotrophic factor(BDNF)]and serum neuroptosis indexes[soluble apoptosis-related factors(sFas)and soluble apoptosis-related factor ligand(sFasL)]of two groups were compared.Result:The revascularization rate of the observation group was significantly higher than that of the control group,the thrombectomy times was significantly less than that of the control group,the revascularization time was significantly shorter than that of the control group,the differences were statistically significant(P<0.05).Before the treatment,the NIHSS scores situation,serum nerve injury indexes and neuroptosis indexes of two groups were compared,the differences were not statistically significant(P>0.05);at 48 h and 14 d after the treatment,the NIHSS scores situation of the observation group were significantly better than those of the control group,at 48 and 72 h after the treatment,the serum BDNF were significantly higher than those of control group,other nerve injury indexes and neuroptosis indexes were significantly lower than those of control group,the differences were statistically significant(P<0.05).Conclusion:The effect of intravenous thrombolysis bridging stent combined with aspiration thrombectomy in acute occlusion of intracranial large vessels is better,and it can effectively control the neuroptosis.