阿替普酶静脉溶栓治疗急性脑梗死的临床效果分析

Clinical Efficacy Analysis of Intravenous Thrombolysis with Ateplase in the Treatment of Acute Cerebral Infarction

目的评估阿替普酶(alteplase,rt-PA)静脉溶栓应用在急性脑梗死(acute cerebral infarction,ACI)患者中的临床效果。方法目的选取在京山仁和医院于2019年1月—2022年12月接受静脉溶栓治疗的90例ACI患者为研究对象,根据治疗方法不同,分为对照组和观察组,各45例。对照组选用尿激酶治疗、观察组选用rt-PA,比较两组间临床有效率、神经因子、凝血功能的差异。结果对照组的总有效率为77.78%(35/45),低于对照组的95.56%(43/45),差异有统计学意义(χ^(2)=6.154,P<0.05)。与对照组相比,观察组的中枢神经特异性蛋白、神经元特异性烯醇化酶水平更低,神经生长因子水平更高,差异有统计学意义(P均<0.05)。与对照组相比,观察组的凝血酶原时间、凝血酶时间更长,纤维蛋白原更低,差异有统计学意义(P均<0.05)。结论对ACI患者实施rt-PA静脉溶栓,可以提高临床有效率,调节神经因子水平,且不易影响凝血功能。

Objective To evaluate the clinical efficacy of intravenous thrombolysis using alteplase(rt-PA)in patients with acute cerebral infarction(ACI).Methods Ninety ACI patients who received intravenous thrombolytic therapy in Jingshan Renhe Hospital from January 2019 to December 2022 were purposefully selected as the study subjects.According to different treatment methods,they were divided into control group and observation group,with forty-five cases in each group.The control group was treated with urokinase,and the observation group was treated with rt-PA.The differences of clinical efficiency,nerve factors and coagulation function between the two groups were compared.Results The total effective rate of the control group was 77.78%(35/45),which was lower than 95.56%(43/45)of the control group,and the difference was statistically significant(χ^(2)=6.154,P<0.05).Compared with the control group,the levels of central nervous system-specific protein and neuron-specific enolase were lower in the observation group,and the levels of nerve growth factor were higher,and the differences were statistically significant(all P<0.05).Compared with the control group,the prothrombin time and thrombin time in the observation group were longer than those in the control group,and the differences were statistically significant(all P<0.05).Conclusion Intravenous thrombolysis with rt-PA in ACI patients can improve clinical efficacy,regulate neurological biomarker levels,and has minimal impact on coagulation function.