阿替普酶联合依达拉奉右莰醇治疗老年脑梗死患者的效果

Effect of Alteplase Combined with Edaravone Dextrocamphorol in Elderly Patients with Ischemic Stroke

目的探究阿替普酶、依达拉奉右莰醇联合治疗老年脑梗死患者的效果。方法择取漯河市中心医院116例老年脑梗死患者为研究对象,随机分组。两组均行常规治疗,对照组58例接受阿替普酶治疗,研究组58例增加依达拉奉右莰醇治疗。对比两组疗效。结果研究组总有效率较对照组高(P<0.05)。治疗后,两组美国国立卫生院卒中量表(NIHSS)、高级中枢损伤严重程度(MESSS)分值均降低,研究组低于对照组(P<0.05);治疗后,两组脑源性神经营养因子(BDNF)、神经生长因子(NGF)水平均升高,神经元特异性烯醇化酶(NSE)、S100B蛋白水平均降低,研究组优于对照组(P<0.05);治疗后,两组血管内皮生长因子(VEGF)水平均升高,单核细胞趋化因子1(MCP-1)、基质金属蛋白酶-9(MMP-9)、钙黏蛋白(cadherin)水平均降低,研究组优于对照组(P<0.05);两组不良反应发生率差异无统计学意义(P>0.05)。结论阿替普酶、依达拉奉右莰醇联合治疗老年脑梗死患者能够促使神经功能恢复,改善神经因子水平及血管内皮功能,提高疗效,且不良反应较少,具有较高的安全性。

Objective To investigate the effect of alteplase combined with edaravone dextrocamphenol in elderly patients with ischemic stroke.Methods A total of 116 elderly patients with cerebral infarction in Luohe Central Hospital were selected as the study objects and randomly grouped.Both groups received conventional treatment,58 patients in the control group received alteplase treatment,and 58 patients in the observation group received edaravone dexcamphorol treatment.The therapeutic effect of the two groups was compared.Results The total effective rate of observation group was higher than that of control group(P<0.05).After treatment,the National Institutes of health stroke scale(NIHSS)and advanced central injury severity(MESSS)scores of both groups were decreased,and the observation group was lower than the control group(P<0.05).After treatment,the levels of brain-derived neurotrophic factor(BDNF)and nerve growth factor(NGF)were increased,and the levels of neuron-specific enolase(NSE)and S100B protein were decreased in both groups,and the observation group was better than the control group(P<0.05).After treatment,the levels of vascular endothelial growth factor(VEGF)were increased in both groups,and the levels of monocyte chemokine protein-1(MCP-1),matrix metalloproteinase-9(MMP-9)and cadherin were decreased in both groups,and the observation group was better than the control group(P<0.05).The incidence of adverse reactions was compared between the two groups(P>0.05).Conclusion For elderly patients with cerebral infarction,the combination treatment of alteplase and edaravone dextrocamphorol can promote the recovery of nerve function,improve the level of neurofactors and vascular endothelial function,improve the efficacy,and less adverse reactions,with a specific high safety.