rt-PA静脉溶栓治疗脑梗死对于脑周围组织血流动力学的影响

Effects of intravenous thrombolysis with rt-PA on hemodynamics of brain tissue in patients with cerebral infarction

目的:探讨注射用重组人组织纤维蛋白溶酶源激活剂(rt-PA)静脉溶栓治疗脑梗死对于脑周围组织血流动力学的影响。方法:2014年9月~2017年2月选择在我院诊治的脑梗死患者60例作为研究对象,根据随机信封抽签原则分为观察组与对照组各30例,观察组给予rt-PA静脉溶栓治疗,对照组给予常规治疗,记录两组近远期疗效,测定脑周围组织血流动力学变化情况。结果:治疗后28d时观察组与对照组的有效率分别为86.7%和66.7%,观察组的有效率高于对照组。观察组治疗后的大脑中动脉的Vp与Vd值分别为64.20±4.19cm/s和50.27±4.92cm/s,都明显高于治疗前,且都明显高于对照组。治疗后90d观察组的远期预后良好率为76.7%,对照组为56.7%,观察组明显好于对照组。结论:rt-PA静脉溶栓治疗脑梗死具有很好的近远期疗效,作用机制可能与改善脑周围组织血流动力学有关,有很好的应用价值。

Objective To investigate the effects of intravenous thrombolysis with recombinant human tissue plasminogen activator(rt-PA) on hemodynamics of brain tissue in patients with cerebral infarction. Methods From September 2014 to February 2017, 60 cases of patients with cerebral infarction in our hospital were selected as the research object, all the cases were divided into observation group and control group with 30 cases in each group, the observation group was given rt-PA intravenous thrombolytic therapy, the control group was given routine treatment, recorded the long term curative effect of two groups, and werei given the determination of hemodynamic changes of brain tissue. Results After treatment 28 d, the effective rate of the observation group and the control group were 86.7% and 66.7%, respectively, and the effective rate of the observation group was higher than that of the control group. The Vp and Vd values of the middle cerebral artery after treatment in the observation group were 64.20±4.19 cm/s and 50.27±4.92 cm/s, respectively, which were significantly higher than those before treatment, and were significantly higher than that of the control group. After treatment, the long-term prognosis of the 90 d observation group was 76.7%, the control group was 56.7%, and the observation group was significantly better than the control group. Conclusionrt-PA thrombolytic therapy has good short-term and long-term effect on cerebral infarction. The mechanism of action may be related to the improvement of hemodynamicsof brain tissue, so it has good application value.