rt-PA静脉溶栓与丁苯酞注射液治疗急性脑梗死的疗效探究

Therapeutic effect of rt-PA intravenous thrombolysis and butylphthalein injection on acute cerebral infarction

目的研究重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓与丁苯酞注射液治疗急性脑梗死的疗效。方法100例急性脑梗死患者,应用随机数字表法分为对照组和研究组,每组50例。对照组患者采用rt-PA开展静脉溶栓治疗,研究组患者先给予丁苯酞注射液,再采用rt-PA开展静脉溶栓治疗。对比两组治疗前后血液流变学指标、美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分及出血事件发生率。结果对比本组治疗前,两组治疗后全血高切粘度、全血低切粘度、血浆粘度、红细胞压积均明显降低,且研究组全血高切粘度(4.20±0.54)mPa·s、全血低切粘度(10.05±0.98)mPa·s、血浆粘度(1.39±0.40)mPa·s、红细胞压积(31.28±2.36)%均低于对照组的(4.81±0.59)mPa·s、(11.20±1.13)mPa·s、(1.87±0.45)mPa·s、(34.59±3.04)%(P<0.05)。对比本组治疗前,两组治疗后NIHSS评分、mRS评分均明显降低,且研究组NIHSS评分(9.12±2.74)分、mRS评分(1.89±0.62)分低于对照组的(12.54±3.05)、(2.65±0.74)分(P<0.05)。研究组出血事件发生率4.00%低于对照组的18.00%(P<0.05)。结论对于接受静脉溶栓治疗的急性脑梗死患者,在采用rt-PA开展静脉溶栓治疗前应用丁苯酞注射液,可更加有效地改善患者血液流变学,有利于增强神经功能修复效果,改善其预后,还可减少出血事件发生,提高静脉溶栓治疗的安全性。

Objective To study the curative effect of recombinant tissue-type plasminogen activator(rt-PA)intravenous thrombolysis and butylphthalein injection on acute cerebral infarction.Methods 100 patients with acute cerebral infarction were divided into a control group and a study group by random number table method,with 50 cases in each group.The control group was treated with rt-PA for intravenous thrombolytic therapy,while the study group was first treated with butylphthalide injection,followed by rt-PA for intravenous thrombolytic therapy.The hemorheological parameters and National Institutes of Health Stroke Scale(NIHSS)score before and after treatment,modified Rankin scale(mRS)score and incidence of bleeding events were compared between the two groups.Results Compared with those before treatment,the whole blood high-shear viscosity,whole blood low-shear viscosity,plasma viscosity and hematocrit in both groups were significantly reduced after treatment;in the study group,the whole blood high-shear viscosity was(4.20±0.54)mPa·s,the whole blood low-shear viscosity was(10.05±0.98)mPa·s,the plasma viscosity was(1.39±0.40)mPa·s,the hematocrit was(31.28±2.36)%,which were lower than(4.81±0.59)mPa·s,(11.20±1.13)mPa·s,(1.87±0.45)mPa·s,(34.59±3.04)%in the control group(P<0.05).Compared with those before treatment,NIHSS score and mRS score in both groups were significantly decreased after treatment;and NIHSS score of(9.12±2.74)points and mRS score of(1.89±0.62)points in the study group were lower than(12.54±3.05)and(2.65±0.74)points in the control group(P<0.05).The incidence of bleeding events in the study group was 4.00%,which was lower than 18.00%in the control group(P<0.05).Conclusion For patients with acute cerebral infarction receiving intravenous thrombolytic therapy,the application of butylphthalein injection before intravenous thrombolytic therapy with rt-PA can more effectively improve the hemorheology of patients,which is conducive to the enhancement of the effect of neurological function repair and improvement of their prognosis,and it can also reduce the occurrence of bleeding events and improve the safety of intravenous thrombolytic therapy.