阿替普酶联合银杏二萜内酯葡胺治疗磁共振DWI-FLAIR失配急性缺血性脑卒中的临床观察

Clinical observation of alteplase and ginkgo diterpene lactone meglumine on acute ischemic stroke with MRI DWI/FLAIR mismatch

目的观察阿替普酶联合银杏二萜内酯葡胺(GDLM)对磁共振弥散加权成像(MRI DWI)与液体衰减反转恢复成像(FLAIR)失配急性缺血性脑卒中(AIS)的疗效。方法94例MRI-DWI/FLAIR失配AIS患者随机接受阿替普酶(对照组)或阿替普酶联合GDLM(观察组)治疗2周,比较两组疗效、不良反应、血清炎症因子(IL-6、IL-8、IL-1β、hs-CRP)水平、血液流变学指标。结果观察组疗效明显优于对照组(P<0.05),但不良反应差异无统计学意义(P>0.05)。两组治疗后IL-6、IL-8、hs-CRP和IL-1β水平及血液流变学指标均明显低于治疗前,其中观察组更显著(P<0.01或0.05)。结论阿替普酶联合GDLM治疗MRI DWI-FLAIR失配AIS疗效优于单用阿替普酶治疗者,显著降低炎症因子水平和改善血液流变学指标。

Objective To observe the efficacy of combined alteplase and ginkgo diterpene lactone meglumine(GDLM)in acute ischemic stroke(AIS)with magnetic resonance imaging diffusion weighted imaging/fluid attenuated inversion recovery(MRI DWI/FLAIR)mismatch.Methods Ninety-four AIS patients with MRI DWI/FLAIR mismatch were randomly treated with alteplase(control group)or alteplase and GDLM(observation group)for 2 weeks.Clinical efficacy,serum inflammatory factors(IL-6,IL-8,IL-1β,and hs-CRP),hemorheological indicators,and adverse reactions were compared between 2 groups.Results The curative effect was better in observation group than in control group(P<0.05),but no significant difference of adverse reactions was noted between 2 groups(P>0.05).Levels of IL-6,IL-8,hs-CRP and IL-1βand hemorheological parameters were lower after therapy in both groups,especially in observation group(P<0.01 or 0.05).Conclusion Clinical efficacy of combined alteplase and GDLM is superior to that of alteplase in AIS patients with MRI DWI/FLAIR mismatched by reducing inflammatory cytokines and improving hemorheological indicators.