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Effects of butyphthalide + rt-PA intravenous thrombolysis on the DWI characteristics, coagulation function and neurological function in patients with acute cerebral infarction 被引量:1
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作者 Liu Xiao-Bei Hou Xiao-Jun 《Journal of Hainan Medical University》 2019年第19期37-41,共5页
Objective: To investigate the effects of butyphthalide + alteplase (rt-PA) intravenous thrombolysis on the diffusion-weighted imaging (DWI) characteristics, coagulation function and neurological function in patients w... Objective: To investigate the effects of butyphthalide + alteplase (rt-PA) intravenous thrombolysis on the diffusion-weighted imaging (DWI) characteristics, coagulation function and neurological function in patients with acute cerebral infarction. Methods: The patients with acute cerebral infarction who were admitted to our hospital between April 2015 and October 2018 and with the onset time 4.5 hours were selected and divided into the observation group receiving butyphthalide + rt-PA intravenous thrombolysis and the control group receiving rt-PA intravenous thrombolysis by random number table. The differences in DWI parameter apparent diffusion coefficient (ADC), coagulation function indexes and neurological function indexes were compared between the two groups. Results: At 7 and 14 days after treatment, the ADC values of both groups were significantly increased, and the ADC values of the observation group were significantly higher than those of the control group;at 7 days after treatment, the prothrombin time (PT) and activated partial thromboplastin time (APTT) levels in both groups were significantly prolonged whereas fibrinogen (FIB), D-dimer (D-D), platelet activating factor (PAF), P-selectin, von Willebrand factor (vWF), neuron-specific enolase (NSE), S100B protein (S100B), malondialdehyde (MDA) and endothelin-1 (ET-1) contents were significantly decreased, and the APTT and PT levels in the observation group were significantly shorter than those in the control group whereas FIB, D-D, PAF, P-selectin, vWF, NSE, S100B, MDA and ET-1 contents were significantly lower than those in the control group. Conclusion: Butyphthalide + rt-PA intravenous thrombolysis can improve the DWI characteristics, coagulation function and neurological function of patients with acute cerebral infarction. 展开更多
关键词 Acute cerebral infarction Butyphthalide intravenous thrombolysis Coagulation function Neurological function
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The Effect of the Early Application of Tirofiban on Acute Ischemic Stroke (AIS) after Intravenous Thrombolysis with Urokinase
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作者 Mingfen Li 《Journal of Clinical and Nursing Research》 2023年第4期201-204,共4页
Objective:Discussion and analysis of the effect of the early application of Tirofiban on acute ischemic stroke(AIS)after intravenous thrombolysis with urokinase.Method:The subjects of this study are 40 patients with A... Objective:Discussion and analysis of the effect of the early application of Tirofiban on acute ischemic stroke(AIS)after intravenous thrombolysis with urokinase.Method:The subjects of this study are 40 patients with AIS admitted at the Yibin Fourth People’s Hospital,of which were computer-randomized into a control group(20 cases,with regular urokinase intravenous thrombolysis therapy)and a research group(20 cases,combined with early Tirofiban treatment)from January 2018 to December 2022.The intervention outcomes between these two groups were compared and analyzed.Result:The blood platelet-related parameters before treatment had no statistical difference between the two groups(P>0.05),but the research group was higher than that of the control group after treatment(P<0.05).The Barthel index before treatment in both groups had no statistical difference(P>0.05),but the research group was higher than that of the control group after treatment(P<0.05).Conclusion:Early Tirofiban treatment for patients with AIS after intravenous thrombolysis with urokinase could effectively regulate the blood platelet-related parameters,hence improving treatment benefits and living capacity for patients,with definite clinical benefits. 展开更多
关键词 Acute ischemic stroke intravenous thrombolysis with urokinase Tirofiban Treatment effect
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Anticoagulation effect of low-dose and low-intensity heparin applied within 24 hours after intravenous thrombolysis for acute cerebral infarction
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作者 Juan Du Yiling Cai +3 位作者 Wei Li Yongqiang Cui Qiao Wu Jianhui Cai 《Neural Regeneration Research》 SCIE CAS CSCD 2007年第11期665-669,共5页
BACKGROUND: Studies have demonstrated that immediate anticoagulation after thrombolysis can improve the prognosis of patients with acute cerebral infarction. However, the optimal timing and means of anticoagulation t... BACKGROUND: Studies have demonstrated that immediate anticoagulation after thrombolysis can improve the prognosis of patients with acute cerebral infarction. However, the optimal timing and means of anticoagulation therapy remain unclear. OBJECTIVE: To observe the effects and safety of heparin treatment within 24 hours after intravenous thrombolysis for acute cerebral infarction. DESIGN: Observation experiment. SETTING: Department of Neurology, the 306 Hospital of Chinese PLA. PARTICIPANTS: Fifteen acute cerebral infarction patients complicated by moderate and severe neurologic function deficits within 6 hours after attack admitted to Department of Neurology, the 306 Hospital of Chinese PLA between January 2005 and December 2006 were recruited in this study. The involved patients, 11 male and 4 female, were aged 46- 79 years. They all met the diagnosis criteria for various cerebrovascular diseases formulated by the 4th National Conference for Cerebrovascular Disease (1995) and confirmed as cerebral infarction by skull CT or MRI imageology. Informed consents were obtained from the patients or their relatives. METHODS: On admission, patients received thrombolysis with urokinase. Immediately after thrombolysis, skull CT was rechecked. Intracranial hemorrhage signs were not found by skull CT. Hemorrhage was also not found in skin, mucous membrane and internal organs. Six hours later, low-dose low-intensity heparin 4 - 8 IU/kg per hour was intravenously administrated for anticoagulation for 7 - 10 days successively. MAIN OUTCOME MEASURES: Neurologic function was evaluated before, immediately 6 hours and 14 days after thrombolysis by scoring standard of clinical neurologic function deficit degree for stroke patients (1995). Activities of daily living of patients with stroke were evaluated 90 days after thrombolysis by modified Rankin Scale. RESULTS: Fifteen involved patients participated in the final analysis. ① Comparison of clinical neurologic function deficit degree of patients at different time: Neurologic function deficit score at the end of thrombolysis was significantly lower than that before thrombolysis (t =3.45, P 〈 0.01). Neurologic function deficit score 6 hours after thrombolysis was higher than that at the end of thrombolysis, and neurologic deficits were increased, but no significant difference was found (P 〉 0.05). Neurologic function deficit score 14 days after thrombolysis was significantly lower than that before thrombolysis (t =4.769, P 〈 0.01). ②Therapeutic effect and modified Rankin scale results: 14 days after thrombolysis, 4 patients were basically cured, 7 significantly improved, 2 improved and 2 worsened. The total improvement rate of neurologic function deficit was 86.7%. Ninety days after thrombolysis, according to modified Rankin Scale, score was 0 to 2 in 12 patients (80%), 3 to 4 in 2 patients (13.3%) and 6 in 1 patient (6.7%). Complications of intracranial hemorrhage were not found in patients within 14 days after thrombolysis. CONCLUSION: Low-dose and low-intensity heparin applied within 24 hours after intravenous thrombolysis has good safety and efficacy in the treatment of acute cerebral infarction. 展开更多
关键词 cerebral infarction intravenous thrombolysis REPERFUSION HEPARIN
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Clinical study about mild hypothermia + intravenous thrombolysis in promoting the neural functional recovery in patients with acute cerebral infarction
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作者 Qin Tian Chun-Xia Liu Wen-Fang Tian 《Journal of Hainan Medical University》 2018年第4期31-34,共4页
Objective: To explore the efficacy of mild hypothermia + intravenous thrombolysis in promoting the neural functional recovery in patients with acute cerebral infarction. Methods: A total of 176 patients with acute cer... Objective: To explore the efficacy of mild hypothermia + intravenous thrombolysis in promoting the neural functional recovery in patients with acute cerebral infarction. Methods: A total of 176 patients with acute cerebral infarction who were treated in our hospital between September 2015 and February 2017 were reviewed and divided into the routine group (n=100 cases, receiving routine intravenous thrombolysis therapy) and the mild hypothermia group (n=76, receiving mild hypothermia + intravenous thrombolysis therapy), and the treatment lasted for 1 week. The differences in serum levels of nerve injury indexes, inflammatory mediators and neurotransmitters were compared between the two groups before treatment and after 1 week of treatment. Results: Before treatment, there was no statistically significant difference in serum levels of nerve injury indexes, inflammatory mediators and neurotransmitters between the two groups. After 1 week of treatment, serum nerve injury indexes H-FABP, NT-proBNP, NSE and S100B levels of mild hypothermia group were lower than those of routine group;inflammatory mediators sICAM-1, IL-8, IL-13 and IL-18 levels were lower than those of routine group;neurotransmitter Glu level was lower than that of routine group whereas GABA level was higher than that of routine group. Conclusion: mild hypothermia + intravenous thrombolysis therapy can effectively reduce the nerve injury and systemic inflammatory response, and optimize the neurotransmitter distribution in patients with acute cerebral infarction. 展开更多
关键词 Acute cerebral INFARCTION MILD HYPOTHERMIA intravenous thrombolysis NEURAL function
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Evaluation of serological indicators of intravenous thrombolysis bridge stent combined with aspiration embolectomy for intracranial macrovascular infarction
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作者 Ming-Juan Ge Qin Zhao 《Journal of Hainan Medical University》 2018年第22期39-43,共5页
Objective: To explore the effect of intravenous thrombolysis bridge stent combined with aspiration embolectomy on serological indicators in patients with intracranial macrovascular infarction. Methods: 92 patients wit... Objective: To explore the effect of intravenous thrombolysis bridge stent combined with aspiration embolectomy on serological indicators in patients with intracranial macrovascular infarction. Methods: 92 patients with intracranial macrovascular infarction who received treatment in our hospital between February 2016 and January 2018 were selected as the research subjects and divided into the control group (n=46) and the study group (n=46) by random number table method. Control group received stent embolectomy alone, and study group received intravenous thrombolysis bridge stent combined with aspiration embolectomy. The differences in serum levels of inflammatory mediators, chemokines and nerve function-related indexes were compared between the two groups before treatment and 24h after embolectomy. Results: Before treatment, the differences in serum levels of inflammatory mediators, chemokines and nerve function-related indexes were not significant between the two groups. 24h after embolectomy, serum inflammatory mediators sICAM-1, hs-CRP and TNF-α levels of study group were lower than those of control group;serum chemokines CXCL16, Fractalkine and MCP-1 contents were lower than those of control group;serum nerve function-related indexes IGF-1, BDNF and CNTF levels were higher than those of control group whereas NSE level was lower than that of control group. Conclusion:Intravenous thrombolysis bridge stent combined with aspiration embolectomy can effectively reduce the systemic inflammatory response and optimize the nerve function in patients with intracranial macrovascular infarction. 展开更多
关键词 INTRACRANIAL MACROVASCULAR INFARCTION intravenous thrombolysis BRIDGE stent ASPIRATION EMBOLECTOMY Inflammatory response Nerve function
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血清HDAC4和MYD88水平与急性脑梗死rt-PA静脉溶栓后出血转化的关系研究
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作者 刘昌佳 郝洁 +4 位作者 刘敏肖 李银 唐进松 李凡 李鑫 《国际检验医学杂志》 CAS 2024年第11期1313-1317,共5页
目的探讨急性脑梗死(ACI)患者血清组蛋白去乙酰化酶4(HDAC4)和髓样分化蛋白88(MYD88)水平与重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓后发生出血转化的关系。方法选取2020年5月至2022年5月在该院就诊并进行rt-PA静脉溶栓治疗的169例ACI... 目的探讨急性脑梗死(ACI)患者血清组蛋白去乙酰化酶4(HDAC4)和髓样分化蛋白88(MYD88)水平与重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓后发生出血转化的关系。方法选取2020年5月至2022年5月在该院就诊并进行rt-PA静脉溶栓治疗的169例ACI患者作为研究对象,并根据患者进行rt-PA静脉溶栓后是否发生出血转化将其分为转化组(46例)和非转化组(123例),另外选取同期在该院进行体检的156例体检健康者作为对照组。采用酶联免疫吸附试验对各组血清HDAC4、MYD88水平进行检测,并对转化组和非转化组的一般资料进行比较;采用Pearson相关对ACI患者血清HDAC4和MYD88水平的相关性进行分析;采用多因素Logistic回归分析影响ACI患者rt-PA静脉溶栓后出血转化的相关因素;进一步通过受试者工作特征(ROC)曲线评估HDAC4、MYD88水平及二者联合对ACI患者rt-PA静脉溶栓后出血转化的诊断价值。结果ACI组血清HDAC4水平低于对照组,血清MYD88水平高于对照组,差异均有统计学意义(P<0.05);非转化组和转化组ACI患者的性别、年龄、体重指数、空腹血糖及高血脂、冠心病占比比较,差异均无统计学意义(P>0.05),而患者心房颤动占比、美国国立卫生研究院卒中量表(NIHSS)评分、发病至溶栓时间比较,差异均有统计学意义(P<0.05);转化组较非转化组血清HDAC4水平降低,血清MYD88水平升高,差异有统计学意义(P<0.05);Pearson相关分析结果显示,ACI患者血清HDAC4水平与MYD88呈负相关(r=-0.401,P<0.001);多因素Logistic回归分析显示,心房颤动、发病至溶栓时间、NIHSS评分、MYD88水平是ACI患者rt-PA静脉溶栓后发生出血转化的危险因素,HDAC4水平是ACI患者rt-PA静脉溶栓后发生出血转化的保护因素(P<0.05);血清HDAC4、MYD88联合检测ACI患者rt-PA静脉溶栓后发生出血转化的曲线下面积为0.876,灵敏度和特异度分别为65.22%和98.37%,优于HDAC4和MYD88单独诊断(Z二者联合-HDAC4=2.298,P=0.022;Z二者联合-MYD88=2.545,P=0.011)。结论ACI患者血清HDAC4和MYD88水平与rt-PA静脉溶栓后发生出血转化密切相关。 展开更多
关键词 组蛋白去乙酰化酶4 髓样分化蛋白88 急性脑梗死 静脉溶栓 出血转化
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依达拉奉右莰醇在高龄中重度急性缺血性脑卒中rt-PA静脉溶栓治疗中的应用时机
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作者 谷亚伟 楚旭 +9 位作者 赵路静 洪波 罗芝宽 林展增 李强 范宏光 高静珍 董银华 王利军 陈念 《山东医药》 CAS 2024年第2期13-17,共5页
目的 探讨依达拉奉右莰醇在高龄中重度急性缺血性脑卒中(AIS)重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗中的应用时机。方法 选择rt-PA静脉溶栓救治的221例高龄中重度AIS患者,随机分为对照组70例、早期组75例、晚期组76例。对照组接... 目的 探讨依达拉奉右莰醇在高龄中重度急性缺血性脑卒中(AIS)重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗中的应用时机。方法 选择rt-PA静脉溶栓救治的221例高龄中重度AIS患者,随机分为对照组70例、早期组75例、晚期组76例。对照组接受rt-PA静脉溶栓治疗,早期组在rt-PA静脉溶栓治疗启动后即刻给予依达拉奉右莰醇治疗,晚期组在rt-PA静脉溶栓24 h后给予依达拉奉右莰醇治疗。于治疗7 d时采用NIHSS评分评价神经功能改善情况,治疗90 d时采用mRS评分评价预后情况,比较三组短期疗效和长期疗效;观察24 h症状性颅内出血发生率、14 d颅外系统性并发症发生率和90 d病死率,比较三组治疗安全性。结果 三组7 d神经功能改善率、90 d预后良好率比较,早期组和晚期组均高于对照组,且早期组高于晚期组(P均<0.05)。三组24 h症状性颅内出血发生率、14 d颅外系统性并发症发生率比较,早期组低于晚期组和对照组(P均<0.05),晚期组与对照组比较差异无统计学意义(P>0.05)。三组90 d病死率比较,早期组和晚期组均低于对照组,且早期组低于晚期组(P均<0.05)。结论 高龄中重度AIS患者rt-PA静脉溶栓后即刻应用依达拉奉右莰醇可提高rt-PA静脉溶栓治疗的有效性和安全性,减少并发症的发生,改善患者预后。 展开更多
关键词 依达拉奉右莰醇 静脉溶栓 急性缺血性脑卒中 组织型纤溶酶原激活剂
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Early intravenous administration of tirofiban is recommended in patients with acute ischemic stroke treated with alteplase:a meta-analysis
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作者 Yan-Chao Huo Lu Yang +4 位作者 Wen-Jing Zhou Meng Geng Meng Zhang Wen-Bo Zhao Yao-Ming Xu 《Aging Communications》 2023年第1期12-19,共8页
Background:The occurrence of early neurological deterioration following intravenous thrombolysis(IVT)is considered a particularly ominous clinical event and is strongly correlated with poor outcomes.Initiating tirofib... Background:The occurrence of early neurological deterioration following intravenous thrombolysis(IVT)is considered a particularly ominous clinical event and is strongly correlated with poor outcomes.Initiating tirofiban within 24 h after IVT has been suggested as a better treatment option to achieve long-term functional outcomes.However,the rationality of this remedy is a controversial.The purpose of the study was to evaluate the safety and efficacy of early intravenous tirofiban administration after IVT in patients with acute ischemic stroke(AIS).Methods:Databases including PubMed,EMBASE,Cochrane Library,and Web of Science were searched for clinical trials on early tirofiban implementation after IVT in patients with AIS from inception to September 2022.Odds ratios(ORs)were generated for dichotomous variants via meta-analysis using STATA 17.0 MP.Results:Five clinical trials with 725 patients were eligible.The study outcomes demonstrated that early tirofiban administration after IVT was not associated with symptomatic intracranial hemorrhage(OR,0.78;95%confidence interval(CI),0.22–2.74;P=0.70),asymptomatic intracranial hemorrhage(OR,1.11;95%CI,0.52–2.37;P=0.80),systemic bleeding(OR,0.97;95%CI,0.42–2.23;P=0.94),and death(OR,1.05;95%CI,0.47–2.31;P=0.91),but may reduce the incidence of early neurological deterioration(OR,0.09;95%CI,0.02–0.50;P=0.01),and was significantly associated with 90-day excellent(modified Rankin scale score 0–1)(OR,2.01;95%CI,1.35–3.02;P=0.00)and favorable(modified Rankin scale score 0–2)(OR,2.30;95%CI,1.63–3.23;P=0.00)functional outcomes.Conclusion:The early intravenous administration of tirofiban after IVT in patients with AIS may be a safe and effective treatment strategy that improves long-term neurological functional outcomes without increasing the risk of adverse events. 展开更多
关键词 acute ischemic stroke tirofiban ALTEPLASE intravenous thrombolysis META-ANALYSIS
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rt-PA静脉溶栓联合丁苯酞对急性脑梗死患者的疗效分析
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作者 王福平 赖小梅 胡意 《中国医学创新》 CAS 2024年第14期111-115,共5页
目的:探讨阿替普酶(rt-PA)静脉溶栓联合丁苯酞用于急性脑梗死(acute cerebral infarction,ACI)患者治疗中的临床效果。方法:以2022年1月—2023年6月瑞金市人民医院收治的ACI患者82例为研究对象,按随机数字表法分为对照组(脑梗死常规治疗... 目的:探讨阿替普酶(rt-PA)静脉溶栓联合丁苯酞用于急性脑梗死(acute cerebral infarction,ACI)患者治疗中的临床效果。方法:以2022年1月—2023年6月瑞金市人民医院收治的ACI患者82例为研究对象,按随机数字表法分为对照组(脑梗死常规治疗+rt-PA静脉溶栓)、观察组(在对照组基础上联合应用丁苯酞),每组41例。观察对比两组神经功能缺损程度、生活自理能力、临床疗效、血清指标、不良反应发生率及生活质量评分。结果:治疗后两组美国国立卫生研究院卒中量表(national institutes of health stroke scale,NIHSS)评分较治疗前均降低,日常生活活动能力量表(activities of daily living,ADL)、健康调查简易量表(SF-36)评分较治疗前均升高,且观察组均优于对照组,差异均有统计学意义(P<0.05);观察组临床总有效率高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率对比,差异无统计学意义(P>0.05);治疗后两组脑钠肽(brain natriuretic peptide,BNP)、同型半胱氨酸(homocysteine,Hcy)、C反应蛋白(C reactive protein,CRP)水平均较治疗前降低,且观察组均低于对照组,差异均有统计学意义(P<0.05)。结论:ACI患者应用rt-PA静脉溶栓联合丁苯酞治疗,临床效果确切,且安全性高,可促进神经功能恢复,改善预后。 展开更多
关键词 rt-pa 静脉溶栓 丁苯酞 急性脑梗死 神经功能 生活质量
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Th17/Treg与急性脑梗死患者rt-PA溶栓后脑出血发生的相关性
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作者 杨建波 林晓静 +3 位作者 徐金凤 韩佳容 王晓阳 张小宁 《河北医药》 CAS 2024年第5期748-751,共4页
目的分析辅助性T细胞17(Th17)/调节性T细胞(Treg)与急性脑梗死患者重组组织型纤溶酶原激活剂(rt-PA)溶栓治疗后脑出血发生的相关性。方法本研究为前瞻性分析,纳入2021年2月至2023年2月收治的急性脑梗死患者,所有患者行rt-PA溶栓治疗。... 目的分析辅助性T细胞17(Th17)/调节性T细胞(Treg)与急性脑梗死患者重组组织型纤溶酶原激活剂(rt-PA)溶栓治疗后脑出血发生的相关性。方法本研究为前瞻性分析,纳入2021年2月至2023年2月收治的急性脑梗死患者,所有患者行rt-PA溶栓治疗。检测患者溶栓治疗前、后Th17、Treg细胞含量,计算Th17/Treg水平。根据溶栓治疗后复查CT/MRI结果,将患者分为脑出血组和未出血组。采用点二列相关性检验Th17/Treg与急性脑梗死患者rt-PA溶栓治疗后脑出血发生的关系,绘制受试者工作特征曲线分析治疗前Th17/Treg对急性脑梗死患者rt-PA溶栓治疗后脑出血发生的预测价值。结果共纳入403例急性脑梗死患者,其中12例rt-PA溶栓治疗后发生脑出血,占2.98%。治疗前,脑出血组患者Th17/Treg高于未出血组(P<0.05);治疗后,2组患者Th17/Treg较治疗前降低,且脑出血组患者Th17/Treg高于未出血组,差异有统计学意义(P<0.05)。经点二列相关性分析,Th17/Treg与急性脑梗死患者rt-PA溶栓治疗后脑出血发生呈正相关(r=0.217,P<0.001)。绘制受试者工作特征曲线,Th17/Treg对急性脑梗死患者rt-PA溶栓治疗后脑出血发生有一定预测价值(AUC=0.809,P<0.001)。结论Th17/Treg指标与急性脑梗死患者rt-PA溶栓治疗后脑出血发生有关,且能预测治疗后脑出血发生情况。 展开更多
关键词 急性脑梗死 脑出血 静脉溶栓 辅助性T细胞17 调节性T细胞
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Evaluation of vascular recanalization rate and nerve injury of mechanical thrombectomy combined with rt-PA thrombolysis in treatment of acute cerebral infarction
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作者 Ming-Shu Zhang Ming-Ze Chang Meng Lin 《Journal of Hainan Medical University》 2019年第12期32-36,共5页
Objective:To investigate the vascular recanalization rate of mechanical thrombectomy combined with recombinant tissue-type plasminogen activator (rt-PA) thrombolysis in the treatment of acute cerebral infarction and t... Objective:To investigate the vascular recanalization rate of mechanical thrombectomy combined with recombinant tissue-type plasminogen activator (rt-PA) thrombolysis in the treatment of acute cerebral infarction and the effect on the nerve injury in patients.Methods:A total of 90 patients with acute cerebral infarction who were treated in our hospital between January 2016 and January 2019 were retrospectively analyzed and divided into the control group (n=46) receiving rt-PA thrombolysis and the observation group (n=44) receiving mechanical thrombectomy combined with rt-PA thrombolysis. The differences in vascular recanalization rate 24 h after treatment as well as serum levels of inflammatory mediators [interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-7 (IL-7), interleukin-17 (IL-17) and hypersensitive C-reactive protein (hs-CRP)], nerve injury markers [brain-derived neurotrophic factor (BDNF), neuron-specific enolase (NSE) and S100B protein (S100B)] and neurotransmitters [glutamate (Glu) and 5-hydroxytryptamine (5-HT)] before and after treatment were compared between the two groups of patients.Results: 24 h after treatment, the vascular recanalization rate of the observation group was higher than that of the control group (P<0.05). 24 h after treatment and 1 week after treatment, serum IL-1, IL-6, IL-7, IL-17 and hs-CRP levels in the observation group were lower than those in the control group;BDNF level was higher than that in the control group, while NSE and S100B levels were lower than those in the control group;Glu and 5-HT levels were lower than those in the control group (P<0.05). Conclusions: Mechanical thrombectomy combined with rt-PA thrombolysis can increase the early postoperative vascular recanalization rate in patients with acute cerebral infarction, and it also plays an active role in alleviating nerve injury. 展开更多
关键词 Acute cerebral INFARCTION Mechanical THROMBECTOMY rt-pa thrombolysis VASCULAR RECANALIZATION rate Nerve injury
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丁苯酞注射液对急性脑梗死rt-PA静脉溶栓患者的应用研究
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作者 袁俊 《安徽医专学报》 2024年第1期29-31,共3页
目的:探讨丁苯酞注射液对急性脑梗死重组人组织型纤溶酶原激活物(rt-PA)静脉溶栓患者炎性反应及血管内皮功能的影响。方法:纳入医院收治的60例急性脑梗死患者作为研究对象,随机分作予以rt-PA静脉溶栓治疗的对照组以及辅以丁苯注射液治... 目的:探讨丁苯酞注射液对急性脑梗死重组人组织型纤溶酶原激活物(rt-PA)静脉溶栓患者炎性反应及血管内皮功能的影响。方法:纳入医院收治的60例急性脑梗死患者作为研究对象,随机分作予以rt-PA静脉溶栓治疗的对照组以及辅以丁苯注射液治疗的观察组,比较两组神经功能、炎性反应、血管内皮功能及安全性。结果:经治疗后,两组患者NIHSS、NSE均有降低,观察组患者低于对照组(P<0.05);两组患者hs-CRP、sICAM-1均见下降,观察组患者低于对照组(P<0.05);两组患者ET-1、MDA均见下降,观察组患者低于对照组(P<0.05);两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:丁苯酞注射液治疗急性脑梗死rt-PA静脉溶栓患者,可以促进其神经功能恢复,减轻炎性反应,增强血管内皮功能,且不增加不良反应发生风险,具有较高安全性。 展开更多
关键词 急性脑梗死 静脉溶栓 支架取栓 神经功能
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rt-PA静脉溶栓与丁苯酞注射液治疗急性脑梗死的疗效探究
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作者 林晶倩 《中国实用医药》 2024年第4期89-92,共4页
目的研究重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓与丁苯酞注射液治疗急性脑梗死的疗效。方法100例急性脑梗死患者,应用随机数字表法分为对照组和研究组,每组50例。对照组患者采用rt-PA开展静脉溶栓治疗,研究组患者先给予丁苯酞注射液... 目的研究重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓与丁苯酞注射液治疗急性脑梗死的疗效。方法100例急性脑梗死患者,应用随机数字表法分为对照组和研究组,每组50例。对照组患者采用rt-PA开展静脉溶栓治疗,研究组患者先给予丁苯酞注射液,再采用rt-PA开展静脉溶栓治疗。对比两组治疗前后血液流变学指标、美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分及出血事件发生率。结果对比本组治疗前,两组治疗后全血高切粘度、全血低切粘度、血浆粘度、红细胞压积均明显降低,且研究组全血高切粘度(4.20±0.54)mPa·s、全血低切粘度(10.05±0.98)mPa·s、血浆粘度(1.39±0.40)mPa·s、红细胞压积(31.28±2.36)%均低于对照组的(4.81±0.59)mPa·s、(11.20±1.13)mPa·s、(1.87±0.45)mPa·s、(34.59±3.04)%(P<0.05)。对比本组治疗前,两组治疗后NIHSS评分、mRS评分均明显降低,且研究组NIHSS评分(9.12±2.74)分、mRS评分(1.89±0.62)分低于对照组的(12.54±3.05)、(2.65±0.74)分(P<0.05)。研究组出血事件发生率4.00%低于对照组的18.00%(P<0.05)。结论对于接受静脉溶栓治疗的急性脑梗死患者,在采用rt-PA开展静脉溶栓治疗前应用丁苯酞注射液,可更加有效地改善患者血液流变学,有利于增强神经功能修复效果,改善其预后,还可减少出血事件发生,提高静脉溶栓治疗的安全性。 展开更多
关键词 急性脑梗死 静脉溶栓 重组组织型纤溶酶原激活剂 丁苯酞注射液
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急性大脑中动脉M1段闭塞脑梗死患者低剂量rt-PA静脉溶栓后桥接取栓与直接动脉取栓的临床价值
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作者 张茴燕 谷松 +3 位作者 王璐 曹铭华 江顺福 吴明超 《当代医学》 2024年第7期105-108,共4页
目的探讨急性大脑中动脉M1段闭塞脑梗死患者低剂量rt-PA静脉溶栓后桥接取栓与直接动脉取栓的临床价值。方法选取2021年6月至2022年6月景德镇市第一人民医院收治的80例急性大脑中动脉M1段闭塞脑梗死患者作为研究对象,根据患者及家属意愿... 目的探讨急性大脑中动脉M1段闭塞脑梗死患者低剂量rt-PA静脉溶栓后桥接取栓与直接动脉取栓的临床价值。方法选取2021年6月至2022年6月景德镇市第一人民医院收治的80例急性大脑中动脉M1段闭塞脑梗死患者作为研究对象,根据患者及家属意愿分为A组与B组,每组40例。A组行直接动脉取栓治疗,B组行静脉溶栓后桥接动脉取栓治疗。比较两组血管开通率、病死率、不良事件发生率、美国国立卫生院卒中量表(NIHSS)及改良Rankin评分量表(mRS)评分。结果B组血管开通率高于A组,差异有统计学意义(P<0.05)。两组不良事件总发生率比较差异无统计学意义。治疗前、治疗后24 h,两组NIHSS评分比较差异无统计学意义;治疗后3、7 d,B组NIHSS评分均低于B组,差异有统计学意义(P<0.05)。治疗3个月后,B组mRS评分低于A组,差异有统计学意义(P<0.05)。两组病死率比较差异无统计学意义。结论低剂量rt-PA静脉溶栓后桥接动脉取栓治疗急性大脑中动脉M1段闭塞脑梗死安全、有效,可提高血管开通率,且可改善患者预后,值得临床推广应用。 展开更多
关键词 急性大脑中动脉M1段闭塞脑梗死 直接动脉取栓 低剂量rt-pa静脉溶栓后桥接动脉取栓 临床价值
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阿加曲班联合rt-PA静脉溶栓治疗急性后循环缺血性脑卒中的效果及对脑氧代谢指标的影响
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作者 刘晓虎 王新波 +2 位作者 王茹 苏建平 闫小峰 《临床医学研究与实践》 2024年第7期65-68,共4页
目的探讨阿加曲班联合重组组织型纤溶酶原激活物(rt-PA)静脉溶栓治疗急性后循环缺血性脑卒中的效果及对脑氧代谢指标的影响。方法选择2020年4月至2022年3月收治的90例急性后循环缺血性脑卒中患者为研究对象,按照随机数字表法将其分为对... 目的探讨阿加曲班联合重组组织型纤溶酶原激活物(rt-PA)静脉溶栓治疗急性后循环缺血性脑卒中的效果及对脑氧代谢指标的影响。方法选择2020年4月至2022年3月收治的90例急性后循环缺血性脑卒中患者为研究对象,按照随机数字表法将其分为对照组与观察组,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加阿加曲班治疗。比较两组的治疗效果。结果观察组的治疗总有效率高于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的胶质原纤维酸性蛋白(GFAP)、神经元特异性烯醇化酶(NSE)、S100β蛋白水平均低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的动脉血氧含量(CaO2)高于对照组,脑氧摄取率(CEO2)、动静脉血氧含量差低于对照组,差异具有统计学意义(P<0.05)。结论阿加曲班联合rt-PA静脉溶栓治疗急性后循环缺血性脑卒中的效果满意,能降低神经损伤标志物水平,平衡脑氧代谢状态,值得推广。 展开更多
关键词 阿加曲班 重组组织型纤溶酶原激活物 静脉溶栓 急性后循环缺血性脑卒中 脑氧代谢
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rt-PA静脉溶栓治疗伴有HMCAS急性脑梗死患者的临床效果及对血清t-PA、PAI-1水平和免疫功能的影响
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作者 梁浩 《临床医学研究与实践》 2024年第12期52-55,共4页
目的探讨重组组织型纤溶酶原激活物(rt-PA)治疗伴有大脑中动脉高密度征(HMCAS)急性脑梗死患者的临床效果及对血清组织型纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制物1(PAI-1)水平和免疫功能的影响。方法选取2020年3月至2022年6月在我院... 目的探讨重组组织型纤溶酶原激活物(rt-PA)治疗伴有大脑中动脉高密度征(HMCAS)急性脑梗死患者的临床效果及对血清组织型纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制物1(PAI-1)水平和免疫功能的影响。方法选取2020年3月至2022年6月在我院治疗的132例伴有HMCAS急性脑梗死患者的临床资料进行研究,根据治疗方案将其分为对照组(n=66)和观察组(n=66)。对照组给予常规治疗,观察组在此基础上给予rt-PA静脉溶栓治疗。比较两组的治疗效果。结果治疗7 d后,两组的美国国立卫生研究院卒中量表(NIHSS)评分均降低,且观察组显著低于对照组(P<0.05)。治疗7 d后,观察组的t-PA水平显著高于对照组,PAI-1水平显著低于对照组(P<0.05)。治疗7 d后,两组的CD3^(+)、CD4^(+)、免疫球蛋白G(IgG)和免疫球蛋白M(IgM)水平高于治疗前,且观察组显著高于对照组(P<0.05)。观察组的Barthel指数评分、改良Rankin量表(mRS)评分0~2分占比明显高于对照组(P<0.05)。结论rt-PA静脉溶栓治疗伴有HMCAS急性脑梗死效果较好,可有效改善患者t-PA、PAI-1水平,提升免疫功能,且安全性较高。 展开更多
关键词 重组组织型纤溶酶原激活物 大脑中动脉高密度征 急性脑梗死 免疫功能 静脉溶栓
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血清sLOX-1、ESM-1对急性缺血性脑卒中患者rt-PA静脉溶栓后发生出血转化的预测价值
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作者 赵浩 王敏博 张子豪 《检验医学与临床》 2024年第3期333-337,共5页
目的探讨血清可溶性凝集素样氧化型低密度脂蛋白受体-1(sLOX-1)、内皮细胞特异性分子-1(ESM-1)对急性缺血性脑卒中(AIS)患者重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗后发生出血转化(HT)的预测价值。方法选择2020年1月至2022年6月... 目的探讨血清可溶性凝集素样氧化型低密度脂蛋白受体-1(sLOX-1)、内皮细胞特异性分子-1(ESM-1)对急性缺血性脑卒中(AIS)患者重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗后发生出血转化(HT)的预测价值。方法选择2020年1月至2022年6月在宝鸡市人民医院接受rt-PA静脉溶栓治疗的AIS患者320例为研究对象,根据治疗后头颅CT复查结果分为HT组和非HT组,采用酶联免疫吸附试验检测两组患者的血清sLOX-1、ESM-1水平,并进行比较;采多因素Logistic回归分析rt-PA静脉溶栓后发生HT的影响因素;采用受试者工作特征(ROC)曲线分析血清sLOX-1、ESM-1对rt-PA静脉溶栓后发生HT的预测价值。结果治疗36 h后,47例患者发生HT(HT组),HT发生率为14.69%(47/320),剩余273例未发生HT患者为非HT组。HT组年龄、合并高血压患者占比、入院时NIHSS评分、治疗前血清sLOX-1和ESM-1水平高于非HT组(P<0.05)。多因素Logistic回归分析结果显示,入院时NIHSS评分>13.04分、血清sLOX-1>0.92 ng/mL、血清ESM-1>1.24μg/mL是AIS患者静脉溶栓后发生HT的独立危险因素(P<0.05)。治疗前血清sLOX-1、ESM-1单独及联合检测预测rt-PA静脉溶栓后发生HT的曲线下面积(AUC)分别为0.797、0.775和0.840。结论血清sLOX-1、ESM-1是AIS患者rt-PA静脉溶栓后发生HT的影响因素,二者联合检测对其具有较高的预测价值。 展开更多
关键词 可溶性凝集素样氧化型低密度脂蛋白受体-1 内皮细胞特异性分子-1 急性缺血性脑卒中 重组组织型纤溶酶原激活剂静脉溶栓 出血转化 预测价值
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急性脑梗死患者rt-PA静脉溶栓治疗预后情况及相关影响因素分析
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作者 冯陆 韩凯 《临床医学工程》 2023年第5期725-726,共2页
目的探讨急性脑梗死患者阿替普酶(rt-PA)静脉溶栓治疗的预后情况,并分析其相关影响因素。方法将120例急性脑梗死患者随机分为对照组(60例)和观察组(60例)。对照组予以常规治疗,观察组在对照组基础上予以rt-PA静脉溶栓治疗,比较两组患者... 目的探讨急性脑梗死患者阿替普酶(rt-PA)静脉溶栓治疗的预后情况,并分析其相关影响因素。方法将120例急性脑梗死患者随机分为对照组(60例)和观察组(60例)。对照组予以常规治疗,观察组在对照组基础上予以rt-PA静脉溶栓治疗,比较两组患者治疗后3个月的神经功能(NIHSS评分)、日常活动能力(BI评分)及预后情况(m RS评分)。根据mRS评分将观察组分为预后良好和预后不佳两个亚组,并通过单、多因素Logistic模型分析影响其预后的相关因素。结果治疗后3个月,观察组的NIHSS、mRS评分低于对照组,BI评分高于对照组(P<0.05)。观察组预后良好53例,预后不佳7例;经单因素和多因素Logistic分析显示,心脏疾病史、糖尿病、营养状况是影响观察组患者预后的独立因素(P<0.05)。结论rt-PA静脉溶栓治疗有利于急性脑梗死患者预后恢复,而心脏疾病史、糖尿病、营养不良会影响其预后情况。 展开更多
关键词 rt-pa静脉溶栓 急性脑梗死 预后 影响因素
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依达拉奉右莰醇结合rt-PA静脉溶栓治疗急性脑梗死的临床疗效及对患者血清氧化应激水平的影响
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作者 江齐群 包青滢 《中国实用医药》 2023年第22期87-90,共4页
目的分析依达拉奉右莰醇结合重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗急性脑梗死(ACI)的临床疗效及对患者血清氧化应激水平的影响。方法选取124例ACI患者为研究对象,应用随机数字表法分为研究组与对照组,各62例。对照组给予rt-PA... 目的分析依达拉奉右莰醇结合重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗急性脑梗死(ACI)的临床疗效及对患者血清氧化应激水平的影响。方法选取124例ACI患者为研究对象,应用随机数字表法分为研究组与对照组,各62例。对照组给予rt-PA静脉溶栓治疗,研究组在对照组基础上加用依达拉奉右莰醇治疗。对比两组治疗前、治疗2周后血清氧化应激水平、日常生活能力、神经功能及治疗效果。结果治疗前,两组丙二醛(MDA)、血清谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)水平对比,差异无统计学意义(P>0.05)。治疗后,两组MDA水平低于本组治疗前,GSH-Px、SOD水平高于本组治疗前,且研究组MDA(6.20±1.35)nmol/ml低于对照组的(9.44±1.83)nmol/ml,GSH-Px(94.35±14.29)U/L、SOD(325.85±28.87)U/ml高于对照组的(73.38±13.06)U/L、(250.17±30.16)U/ml,差异有统计学意义(P<0.05)。治疗前,两组Barthel指数(BI)评分、美国国立卫生研究院卒中量表(NIHSS)评分对比,差异无统计学意义(P>0.05)。治疗后,两组BI评分高于本组治疗前,NIHSS评分低于本组治疗前,且研究组BI评分(68.29±5.19)分高于对照组的(54.12±5.03)分,NIHSS评分(5.86±1.47)分低于对照组的(9.58±1.96)分,差异有统计学意义(P<0.05)。研究组治疗总有效率95.16%高于对照组的82.26%,差异有统计学意义(P<0.05)。结论依达拉奉右莰醇结合rt-PA静脉溶栓治疗ACI能在较大程度上改善患者血清氧化应激水平与神经功能,提升其日常生活能力,提高患者整体疗效。 展开更多
关键词 急性脑梗死 依达拉奉右莰醇 重组组织型纤溶酶原激活剂 静脉溶栓 血清氧化应激因子 日常生活能力 神经功能
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头颅MRI指导的rt-PA静脉溶栓后脑出血的危险因素 被引量:1
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作者 李敏 魏丽 +5 位作者 王玲玲 李锦师 陆练军 沈健 白青科 赵晓晖 《脑与神经疾病杂志》 CAS 2023年第8期517-521,共5页
目的 确定头颅MRI指导的rt-PA静脉溶栓后脑出血的危险因素。方法 收集rt-PA静脉溶栓患者临床数据,分析出血组和未出血组诸因素有无统计学差异。结果 与未出血组相比,头颅MRI指导的静脉溶栓后出血组溶栓前NIHSS、溶栓合并取栓、发病至溶... 目的 确定头颅MRI指导的rt-PA静脉溶栓后脑出血的危险因素。方法 收集rt-PA静脉溶栓患者临床数据,分析出血组和未出血组诸因素有无统计学差异。结果 与未出血组相比,头颅MRI指导的静脉溶栓后出血组溶栓前NIHSS、溶栓合并取栓、发病至溶栓时间>4.5h,P<0.05。而多因素回归分析发现重度脑梗死(NIHSS≥21分)、溶栓合并取栓是头颅MRI指导的静脉溶栓患者脑出血的独立危险因素。结论 头颅MRI指导的rt-PA静脉溶栓后脑出血的独立危险因素为重度脑卒中(NIHSS≥21分)和溶栓合并取栓,而与其他因素无关。 展开更多
关键词 头颅MRI 静脉溶栓 急性脑梗死 脑出血 危险因素
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