阿替普酶和尿激酶治疗急性缺血性脑卒中患者疗效及血清指标的影响

Effects of Alteplase and Urokinase on Therapeutic Efficacy and Serum Indexes in Patients with Acute Ischemic Stroke

目的探讨阿替普酶和尿激酶用于急性缺血性脑卒中(AIS)患者治疗中对提高临床疗效及改善血清指标的显著效果。方法于:2021年10月—2022年10月阶段采集病例展开研究,实施对象为201例AIS患者,经严格纳排标准后分组,组别对照组(应用尿激酶静脉溶栓)132例与观察组(应用阿替普酶静脉溶栓)69例;判定患者神经功能及卒中后恢复情况,检测大脑中动脉血流动力学指标、凝血功能指标、血液流变学指标的变化,统计不良预后发生情况,以上数据两组对比。结果较治疗前NIHSS、mRS评分评定,患者治疗后其评分呈下降趋势,且观察组均更低(P<0.05);患者治疗后动脉血流动力学指标均升高,且观察组收缩期峰值、舒张末期及平均流速均更高(P<0.05);较治疗前凝血功能指标,患者治疗后PT、APTT、TT均延长,FIB均下降,D-D均升高,且观察组以上因子水平更优(P<0.05);较治疗前血液流变学指标,患者治疗后血浆粘度、全血高切粘度、红细胞聚集指数及血细胞容积检测结果均下降,且观察组水平更低(P<0.05)。结论于AIS治疗中应用阿替普酶治疗,可有效改善凝血功能,调节血液流变学,以减轻神经损伤,促进神经功能恢复,整体疗效较尿激酶更优,取得良好预后。

Objective To investigate the significant effect of alteplase and urokinase on improving clinical efficacy and serum indexes in patients with acute ischemic stroke(AIS).Methods A total of 201 patients with AIS were collected from October 2021 to October 2022 for the study.The patients were divided into two groups,132 patients in the control group(intravenous thrombolytic therapy with urokinase)and 69 patients in the observation group(intravenous thrombolytic therapy with alteplase).The neurological function and post-stroke recovery of the patients were determined,the changes in the blood flow dynamics index,coagulation function index and hemorheology index of the middle cerebral artery were detected,and the occurrence of adverse prognosis was counted.The above data were compared between the two groups.Results Compared with the scores of NIHSS and mRS Before treatment,the scores of patients after treatment showed a downward trend,and were lower in the observation group(P<0.05).After treatment,the arterial hemodynamic indexes were increased,and the peak systolic period,end diastolic period and average flow velocity were higher in the observation group(P<0.05).Compared with the clotting function index before treatment,PT,APTT and TT were extended after treatment,FIB was decreased,D-D was increased,and the above factors were better in the observation group(P<0.05).Compared with hemorheological indexes before treatment,plasma viscosity,whole blood high shear viscosity,red blood cell aggregation index and blood cell volume test results of patients after treatment were all decreased,and the levels of observation group were lower(P<0.05).Conclusion The application of alteplase in the treatment of AIS can effectively improve the coagulation function,regulate the hemorheology,reduce nerve damage and promote the recovery of nerve function.The overall efficacy is better than urokinase,and the prognosis is good.