摘要
目的探讨静脉溶栓联合尤瑞克林治疗轻型卒中的临床获益与风险。方法回顾性分析86例轻型卒中患者的临床资料,采用静脉溶栓联合尤瑞克林治疗者纳入观察组(n=48),单纯采用静脉溶栓治疗者纳入对照组(n=38)。比较治疗前及治疗2周后,两组灶侧影像学血流灌注参数[血流量(CBF)、平均通过时间(MTT)、达峰时间(TTP)],屏气试验结果参数[脑血管储备能力(CVR)、屏气指数(BHI)],血清生化指标[血管内皮细胞生长因子(VEGF),碱性成纤维细胞生长因子(b FGF)]变化;分析疗程内两组药物不良反应发生情况及治疗后3个月时康复效果[美国国立卫生研究院卒中量表(NIHSS)、改良Rankin量表(mRS)]。结果治疗2周后,两组灶侧CBF、CVR、BHI及血清VEGF、b FGF水平均较治疗前明显提升(P<0.05),且观察组明显高于同期对照组(P<0.05);两组灶侧MTT、TTP水平均较治疗前明显下降(P<0.05),且观察组明显低于同期对照组(P<0.05)。疗程内两组各项药物不良反应发生率比较差异均无统计学意义(P>0.05)。治疗后3个月时,两组康复有效率比较差异无统计学意义(P>0.05),但组间Mann-Whitney U秩和检验结果显示,观察组整体康复效果明显优于对照组,差异有统计学意义(P<0.05)。结论轻型卒中患者采用静脉溶栓有一定的治疗效果,安全性在临床可控范围内,而联合尤瑞克林治疗可获得较为理想的远期预后,对其神经功能恢复有利。
Objective To explore the clinical benefits and risks of intravenous thrombolysis combined with urinary kallidinogenase in the treatment of minor stroke.Methods The clinical data of 86 patients with minor stroke were retrospectively analyzed.Patients who received intravenous thrombolysis combined with urinary kallidinogenase were included in observation group(n=48),and those who received intravenous thrombolysis alone were included in control group(n=38).Before treatment and after 2 weeks of treatment,the imaging blood flow perfusion parameters[cerebral blood flow(CBF),mean transit time(MTT),time to peak(TTP)],and breath holding test indexes[cerebral vascular reactivity(CVR),breath holding index(BHI)]and serum biochemical indicators[vascular endothelial growth factor(VEGF),basic fibroblast growth factor(b FGF)]were compared between the two groups.The occurrence of adverse drug reactions during course of treatment and rehabilitation effects at 3 months after treatment[US National Institutes of Health Stroke Scale(NIHSS),modified Rankin Scale(mRS)]were analyzed in the two groups.Results After 2 weeks of treatment,the CBF,CVR,BHI and serum levels of VEGF and b FGF in the two groups were significantly higher than those before treatment,and the indexes in observation group were significantly higher than those in control group(P<0.05).The MTT and TTP levels in the two groups were significantly higher than those before treatment,and the levels in observation group were significantly higher than those in control group(P<0.05).There was no significant difference in the incidence rate of adverse drug reactions between the two groups during course of treatment(P>0.05).At 3 months after treatment,there was no statistically significant difference in the effective rate of rehabilitation between the two groups(P>0.05),but the Mann-Whitney U rank sum test between-groups showed that the overall rehabilitation effects in observation group were significantly better than those in control group(P<0.05).Conclusions Intravenous thrombolysis has certain treatment effects in patients with minor stroke,and its safety is within the clinical controllable range.Combined with urinary kallidinogenase can obtain ideal longterm prognosis,and it is beneficial to the recovery of neurological function.
作者
周强
林萍
池丽芬
林静
池万章
夏凯
Zhou Qiang;Lin Ping;Chi Lifen;Lin Jing;Chi Wanzhang;Xia Kai(Department of Neurology,the Third Affiliated Hospital of Wenzhou Medical University,Ruian 325200,China)
出处
《中国医师杂志》
CAS
2019年第12期1794-1797,1802,共5页
Journal of Chinese Physician
基金
温州市科技局课题(Y20160259)~~
关键词
卒中
血栓溶解疗法
尤瑞克林
预后
Stroke
Thrombolytic therapy
Urinary kallidinogenase
Prognosis
