| 刘 炜,佟俊萍,张换立,高 超,赵 林.rt-PA动脉溶栓联合血管内支架成形术对早期急性脑梗死患者纤溶系统和血清神经功能损伤指标的影响[J].,2022,(5):960-964 |
| rt-PA动脉溶栓联合血管内支架成形术对早期急性脑梗死患者纤溶系统和血清神经功能损伤指标的影响 |
| Effect of rt-PA Arterial Thrombolysis Combined with Intravascular Stenting on Fibrinolytic System and Serum Nerve Function Injury Indexes in Patients with Early Acute Cerebral Infarction |
| 投稿时间：2021-07-26 修订日期：2021-08-22 |
| DOI：10.13241/j.cnki.pmb.2022.05.033 |
| 中文关键词: rt-PA动脉溶栓 血管内支架成形术 早期急性脑梗死 纤溶系统 神经功能损伤 |
| 英文关键词: rt-PA arterial thrombolysis Intravascular stenting Early acute cerebral infarction Fibrinolytic system Nerve function injury |
| 基金项目:河北省廊坊市科学技术研究与发展计划项目（第一批）自筹经费项目（2019013015）；河北省医学科学研究重点课题项目（20150220） |
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| 中文摘要: |
| 摘要 目的：探讨重组人组织型纤溶酶原激活物（rt-PA）动脉溶栓联合血管内支架成形术治疗早期急性脑梗死（ACI）的疗效及对纤溶系统和血清神经功能损伤指标的影响。方法：选取我院2018年9月~2021年3月间接收的80例早期ACI患者。根据随机数字表法分为对照组38例（rt-PA动脉溶栓治疗）和研究组42例（rt-PA动脉溶栓联合血管内支架成形术治疗）。对比两组血管再通情况、纤溶系统和血清神经功能损伤指标变化、日常生活能力量表（ADL）及美国国立卫生研究院卒中量表（NIHSS）评分，观察两组预后情况。结果：研究组的血管完全再通率高于对照组（P<0.05）。研究组治疗后1 d、治疗后7 d、治疗后3个月NIHSS评分低于对照组，ADL评分高于对照组（P<0.05）。研究组治疗7 d后血管性假血友病因子（vWF）、血浆纤溶酶原激活物抑制剂-1（PAI-1）低于对照组，组织型纤溶酶原激活剂（tPA）高于对照组（P<0.05）。研究组治疗7 d后胶质纤维酸性蛋白（GFAP）、神经元特异性烯醇化酶（NSE）、S100β蛋白低于对照组（P<0.05）。研究组患者的再发脑梗死率、死亡率低于对照组（P<0.05）。结论：rt-PA动脉溶栓联合血管内支架成形术治疗早期ACI患者，可改善患者近远期疗效和预后，有效调节纤溶系统，减轻机体神经功能损伤，提高患者日常生活能力。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the efficacy of recombinant tissue plasminogen activator (rt-PA) arterial thrombolysis combined with intravascular stenting in the treatment of early acute cerebral infarction (ACI) and its effect on fibrinolytic system and serum nerve function injury indexes. Methods: 80 patients with early ACI who were received in our hospital from September 2018 to March 2021 were selected. According to random number table method, they were divided into control group (38 cases, rt-PA arterial thrombolytic therapy) and study group (42 cases, rt-PA arterial thrombolysis combined with intravascular stenting treatment). The vascular recanalization, the changes of fibrinolytic system and serum nerve function injury indexes, the scores of activity of daily living scale (ADL) and National Institutes of Health Stroke Scale(NIHSS) score were compared between the two groups, and the prognosis of the two groups was observed. Results: The complete recanalization rate in the study group was higher than that in the control group(P<0.05). The NIHSS score in the study group was lower than that in the control group at 1d, 7dand 3 months after treatment, and the ADL score was higher than that in the control group(P<0.05). 7 d after treatment, von willebrand factor(vWF) and plasma plasminogen activator inhibitor-1 (PAI-1) in the study group were lower than those in the control group, and tissue plasminogen activator (tPA) was higher than that in the control group(P<0.05). 7 d after treatment, glial fibrillary acidic protein(GFAP), neuron specific enolase (NSE) and S100β protein in the study group were lower than those in the control group(P<0.05). The rate of recurrent cerebral infarction and mortality in the study group were lower than those in the control group(P<0.05). Conclusion: rt-PA arterial thrombolysis combined with intravascular stenting in the treatment of early patients with ACI can improve the short-term and long-term efficacy and prognosis of patients, effectively regulate the fibrinolytic system, reduce neurological impairment, and improve the ability of daily living of patients. |
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