摘要
目的探讨丁苯酞联合阿替普酶静脉溶栓治疗缺血性脑卒中患者的效果。方法104例接受治疗的缺血性脑卒中患者随机均分为阿替普酶组和阿替普酶联合丁苯酞组,治疗2周,收集2组缺血性脑卒中患者的一般资料(性别、年龄、病程、病情程度、病灶部位及基础疾病);抽取2组缺血性脑卒中患者治疗前后的外周静脉血,采用多普勒超声检测仪检测两侧颈动脉的脑血流动力学指标(平均血流速度、动态阻力及外周阻力),采用全自动血气分析仪检测血液流变学指标(红细胞比容、血浆黏度及全血高切黏度),采用酶联免疫吸附法检测血管内皮功能[血管内皮生长因子(vascular endothelial growth factor,VEGF)、一氧化氮(nitric oxide,NO)及内皮素-1(endothelin-1,ET-1)]、神经营养因子水平[胶质细胞源性神经营养因子(glial cell linederived neurotrophic factor,GDNF)、脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)及神经生长因子(nerve growth factor,NGF)]、氧化应激指标[丙二醇(malondialdehyde,MDA)、超氧化物歧化酶(superoxide dismutase,SOD)及谷胱甘肽(glutathione,GSH)]及炎性因子水平[C反应蛋白(C-reactive protein,CRP)、白细胞介秦6(interleukin-6,IL-6)及肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α)];采用美国国立卫生研究院卒中量表(NIHSS)、改良Rankin量表mRS)和Barthel指数(barthel index,BI)评估2组缺血性脑卒中患者治疗前后的神经功能和生活质量。结果阿替普酶联合丁苯酞组患者治疗后的红细胞比容、血浆黏度、全血高切黏度、动态阻力、外周阻力、ET-1、MDA、炎性因子、NIHSS及mRS分数低于阿替普酶组,平均血流速度、VEGF、NO、神经营养因子、SOD、GSH、BI指数高于阿替普酶组,差异均有统计学意义(P<0.05)。结论与单纯阿替普酶静脉溶栓相比,丁苯酞联合阿替普酶静脉溶栓治疗缺血性脑卒中患者可提高治疗效果。
Objective To investigate the effect of intravenous thrombolysis with butylphthalein combined with alteplase on patients with ischemic stroke.Methods A total of 104 patients with ischemic stroke receiving treatment were randomly and equally divided into alteplase group and alteplase combined with butylphthalein group.The treatment lasted for two weeks.The patients in two groups were collected for general data(gender,age,disease duration,severity of condition,lesion location and underlying disease).Peripheral venous blood was extracted from the patients with ischemic stroke in two groups of before and after treatment.A Doppler ultrasound detector was used to detect cerebral hemodynamic indicators in both carotid arteries(mean blood flow velocity,dynamic resistance and peripheral resistance).An automated blood gas analyzer was used to examine hemorheological parameters(hematocrit,plasma viscosity and whole blood high-shear viscosity).Enzyme linked immunosorbent assay(ELISA)was used to detect vascular endothelial function[vascular endothelial growth factor(VEGF),nitric oxide(NO)and endothelin-1(ET-1)],levels of neurotrophic factors[glial cell-derived neurotrophic factor(GDNF),brain-derived neurotrophic factor(BDNF),and nerve growth factor(NGF)],oxidative stress indicators[malondialdehyde(MDA),superoxide dismutase(SOD),and glutathione(GSH)],inflammatory factor levels[C-reactive protein(CRP),interleukin-6(IL-6),and tumor necrosis factor alpha(TNF-α)].Neurological function and quality of life of the patients with ischemic stroke in two groups before and after treatment were evaluated using the National Institutes of Health Stroke Scale(NIHSS),modified Rankin scale(mRS),and Barthel Index(BI).Results After treatment,hematocrit,plasma viscosity,whole blood high shear viscosity,dynamic resistance,peripheral resistance,ET-1,MDA,inflammatory factors,NIHSS,and mRS scores were lower in alteplase combined with butylphthalein group than those in alteplase group,while average blood flow velocity,VEGF,NO,neurotrophic factors,SOD,GSH,and BI indices were higher than those in alteplase group(P<0.5).Conclusion When compared to intravenous thrombolysis with alteplase,intravenous thrombolysis with butylphthalein combined with alteplase may improve the therapeutic effect on patients with ischemic stroke.
作者
高鑫
刘小玲
尹毅丹
李娜
耿琳
GAO Xin;LIU Xiaoling;YIN Yidan;LI Na;GENG Lin(The First Department of Neurology,Shaanxi Provincial People′s Hospital,Xi′an 710068,Shaanxi,China;Department of Neurology,Shenmu Hospital Aff)
出处
《贵州医科大学学报》
2025年第6期917-923,共7页
Journal of Guizhou Medical University
基金
陕西省重点研发计划项目(2021SF-057)。
