静脉溶栓联合介入治疗急性脑梗死的临床疗效及不良反应分析

Clinical efficacy and adverse reactions analysis of intravenous thrombolysis combined with interventional therapy for acute cerebral infarction

目的探究静脉溶栓联合介入治疗急性脑梗死(ACI)的临床疗效及不良反应。方法选取2018年3月至2021年3月莘县人民医院收治的75例ACI患者作为研究对象,随机分为观察组(n=38)与对照组(n=37)。观察组行静脉溶栓联合介入治疗,对照组行静脉溶栓治疗,比较两组血清学相关指标[丙二醛(MDA)、超氧化物歧化酶(SOD)、骨桥蛋白(OPN)、脑利钠肽(BNP)、神经元特异性烯醇化酶(NSE)、中性粒细胞/淋巴细胞比值(NLR)]、美国国立卫生研究院卒中量表(NIHSS)评分、日常生活能力评定Barthel指数(BI)评分、改良Rankin量表(mRS)评分、不良反应发生情况及临床疗效。结果治疗后,两组MDA、OPN、BNP、NSE水平及NLR均低于治疗前,SOD水平均高于治疗前,且观察组MDA、OPN、BNP、NSE水平及NLR均低于对照组,SOD水平均高于对照组,差异有统计学意义(P<0.05)。治疗前,两组NIHSS、BI、mRS评分比较差异无统计学意义;治疗后,两组NIHSS、mRS均低于治疗前,BI评分均高于治疗前,且观察组NIHSS、mRS均低于对照组,BI评分高于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为5.26%,低于对照组的24.32%,差异有统计学意义(P<0.05)。观察组治疗总有效率为92.11%,高于对照组的70.27%,差异有统计学意义(P<0.05)。结论静脉溶栓联合介入治疗ACI疗效确切,能明显抑制患者氧化应激反应,改善神经功能,提高日常生活能力,且不良反应少,值得临床推广应用。

Objective To investigate the clinical efficacy and adverse reactions of intravenous thrombolysis combined with interventional therapy for acute cerebral infarction(ACI).Methods 75 ACI patients admitted to Xinxian People's Hospital from March 2018 to March 2021 were selected as the study subjects,and they were randomly divided into the observation group(n=38)and the control group(n=37).The observation group received intravenous thrombolysis combined with interventional therapy,while the control group received intravenous thrombolysis therapy.The serum related indicators(malondialdehyde[MDA],superoxide dismutase[SOD],osteopontin[OPN],brain natriuretic peptide[BNP],neuron-specific enolase[NSE],neutrophil/lymphocyte ratio[NLR]),National Institutes of Health stroke scale(NIHSS)score,Barthel index(BI)score,modified Rankin scale(mRS)score,incidence of adverse reactions and clinical efficacy were compared between the two groups.Results After treatment,the levels of MDA,OPN,BNP,NSE and NLR of the two groups were lower than before treatment,while the levels of SOD were higher than before treatment,and the levels of MDA,OPN,BNP,NSE,and NLR in the observation group were lower than those in the control group,and the level of SOD was higher than that in the control group,and the differences were statistically significant(P<0.05).After treatment,the NIHSS and mRS of the two groups were lower than before treatment,and the BI score was higher than before treatment,and the NIHSS and mRS in the observation group were lower than those in the control group,and the BI score was higher than that in the control group,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 5.26%,which was lower than 24.32%in the control group,and the difference was statistically significant(P<0.05).The total effective rate in the observation group was 92.11%,which was higher than 70.27%in the control group,and the difference was statistically significant(P<0.05).Conclusion The intravenous thrombolysis combined with interventional therapy for ACI has definite therapeutic effect,can significantly inhibit patients'oxidative stress response,improve neurological function,and enhance daily living ability,and has fewer adverse reactions,which is worthy of clinical promotion and application.