阿替普酶联合丁苯酞对急性脑卒中患者神经功能缺损程度及日常生活能力的影响

Effects of Alteplase Combined with Butylphthalide on Neurological Impairment and Ability of Daily Living in Patients with Acute Stroke

目的探讨阿替普酶联合丁苯酞对急性脑卒中患者神经功能缺损程度及日常生活能力的影响。方法回顾性研究,共选取湖口县人民医院2020年6月至2023年6月期间收治的急性缺血性脑卒中患者80例为对象,按治疗方法不同分为对照组(40例,阿替普酶治疗)和观察组(40例,阿替普酶联合丁苯酞治疗),1个疗程后对比两组治疗效果,神经功能缺损程度、脑梗死面积,炎症反应[白介素-6(IL-6)、白介素-10(IL-10)、超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)],生活质量以及安全性。结果观察组总有效率为95.00%,高于对照组的80.00%,差异有统计学意义(P<0.05)。治疗后,观察组神经功能缺损程度(NIHSS)评分、改良型Rankin量表(mRS)评分、脑梗死面积均低于对照组,差异有统计学意义(P<0.05);Barthel指数高于对照组,差异有统计学意义(P<0.05);观察组IL-6、IL-10、hs-CRP、TNF-α均低于对照组,差异有统计学意义(P<0.05);观察组生活质量优于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论阿替普酶联合丁苯酞在急性脑卒中患者治疗中可获得显著效果,能够有效缓解神经功能缺损程度,提高患者日常生活能力,抑制机体炎症反应,安全可靠,具有较高的临床推广应用价值。

Objective To investigate the effects of alteplase combined with butylphthalide on neurological impairment and ability of daily living in patients with acute stroke.Methods A total of 80 patients with acute ischemic stroke were selected as the subjects,all of whom were admitted to Hukou County People's Hospital from June 2020 to June 2023.According to different treatment methods,they were divided into control group(40 cases,alteplase therapy)and observation group(40 cases,alteplase combined with butylphthalide therapy).After one course of treatment,the therapeutic effect,degree of neurological impairment,infarct size,inflammatory response[interleukin-6(IL-6),interleukin-10(IL-10),hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)],quality of life and safety were compared between the two groups.Results The total effective rate of the observation group was 95.00%higher than that of the control group(80.00%),the difference was statistically significant(P<0.05).After treatment,the neurological impairment(NIHSS)score,the modified Rankin Scale(mRS)score and the cerebral infarction size in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05);the Barthel index was higher than that of the control group,and the difference was statistically significant(P<0.05).IL-6,IL-10,hs-CRP,TNF-αin the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The quality of life in the observation group was better than that in the control group,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Alteplase combined with butylphthalide can achieve significant effects in the treatment of acute stroke patients,which can effectively alleviate neurological impairment,improve the patients'ability of daily living,inhibit the body's inflammatory response,and is safe and reliable,with high clinical application value.