丁苯酞联合rt-PA静脉溶栓对脑梗死患者血清细胞因子及神经功能的影响

Effect of butyphthalide combined with rt-PA intravenous thrombolysis on serum cytokines and nerve function in patients with cerebral infarction

目的探讨丁苯酞联合重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓对脑梗死患者血清细胞因子及神经功能的影响。方法将2016年2月至2017年12月西华县人民医院收治的90例脑梗死患者,按随机对照原则分为两组,各45例。对照组给予rt-PA静脉溶栓治疗,观察组在对照组基础上给予丁苯酞治疗。比较两组患者临床疗效、血清细胞因子水平、神经功能及不良反应情况。结果观察组总有效率(93.33%)高于对照组(75.56%),差异有统计学意义(P<0.05);治疗2周后,两组血清肝细胞生长因子(HGF)、白介素-6(IL-6)和超敏C反应蛋白(hs-CRP)均低于治疗前,观察组低于对照组,差异有统计学意义(P<0.05);治疗90d后,两组神经功能缺损量表(NIHSS)评分低于治疗前,生活活动能力量表(ADL)评分高于治疗前,且观察组评分优于对照组,差异有统计学意义(P<0.05)。结论丁苯酞联合rt-PA静脉溶栓治疗脑梗死,能有效降低患者血清细胞因子水平,改善患者神经功能及生活能力,临床疗效显著,值得临床推广。

Objective To investigate the effect of butyphthalide combined with recombinant tissue plasminogen activator(rt-PA)intravenous thrombolysis on serum cytokines and nerve function in patients with cerebral infarction.Methods Totally 90 patients with cerebral infarction in the hospital from February 2016 to December 2017 were selected,and they were divided into two groups by randomized controlled method,with 45 cases in each group.Control group was given rt-PA intravenous thrombolysis,while observation group was treated with butyphthalide based on control group.The clinical efficacy,serum cytokines,nerve function and adverse reactions were compared between the two groups.Results The total effective rate of observation group(93.33%)was higher than control group(75.56%)(P<0.05);After treatment for 2 weeks,the hepatocyte growth factor(HGF),interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)in two groups were lower than those before treatment,and observation group was lower than control group(P<0.05);After treatment for 90 d,the scores of National Institute of Health stroke scale(NIHSS)in two groups were lower than those before treatment,the activity of daily living(ADL)in two groups were higher than those before treatment,and the scores of observation group were better than those of control group(P<0.05).Conclusion Butyphthalide combined with rt-PA intravenous thrombolysis in treatment of patients with cerebral infarction can effectively decrease the levels of serum cytokines,improve nerve function and ADL,which has significant clinical efficacy and is worthy of clinical promotion.