针对性干预对阿替普酶溶栓治疗急性缺血性脑卒中后认知功能的影响

Effect of targeted intervention on cognitive function after alteplase thrombolytic therapy for acute ischemic stroke

目的探讨针对性干预对阿替普酶溶栓治疗急性缺血性脑卒中后认知功能的影响。方法收集2020年1月至2023年6月亳州市人民医院收治的92例急性缺血性脑卒中患者的临床资料,根据住院期间是否接受了针对性干预将患者分为观察组(n=48)和对照组(n=44)。所有患者均成功接受了阿替普酶静脉溶栓治疗。比较两组患者的急性缺血性脑卒中病情、治疗情况、治疗前后认知功能及住院期间并发症发生情况。结果两组患者发病至溶栓的时间、卒中部位、美国国立卫生研究院卒中量表(NIHSS)评分、缺血灶最大直径及阿替普酶总剂量比较,差异均无统计学意义(P﹥0.05)。治疗后,两组患者蒙特利尔认知功能评估(MoCA)量表中各维度评分均高于本组治疗前,且观察组患者MoCA量表中各维度评分均高于对照组患者,差异均有统计学意义(P﹤0.05)。两组患者住院期间并发症的发生率比较,差异无统计学意义(P﹥0.05)。结论针对性干预可以进一步改善阿替普酶溶栓治疗急性缺血性脑卒中后患者的认知功能,并具有较好的安全性,值得临床推广。

Objective To investigate the effect of targeted intervention on cognitive function in patients with acute ischemic stroke treated with alteplase thrombolytic therapy.Method The clinical data of 92 patients with acute ischemic stroke admitted to the People's Hospital of Bozhou from January 2020 to June 2023 were collected.Depending on whether they received targeted interventions during hospitalization,the patients were divided into observation group(n=48)and control group(n=44).All patients successfully received alteplase intravenous thrombolysis treatment.The acute ischemic stroke condition,treatment status,cognitive function before and after treatment,and incidence of complications during hospitalization of two groups of patients were compared.Result There were no statistically significant differences in the time from onset to thrombolysis,stroke location,National Institute of Health stroke scale(NIHSS)score,maximum diameter of ischemic lesions,and total dose of alteplase between the two groups of patients.After treatment,the scores of each dimension on the Montreal cognitive assessment(MoCA)scale in both groups of patients were higher than those before treatment,and the scores of each dimension on the MoCA scale in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of complications between the two groups of patients during hospitalization(P>0.05).Conclusion Targeted interventions can further improve the cognitive function of patients after acute ischemic stroke treated with alteplase thrombolysis,and have good safety,which is worthy of clinical promotion.