摘要
目的分析金纳多注射液联合重组组织型纤溶酶原激活物(rt-PA)静脉溶栓对急性脑梗死患者神经功能缺损及血清因子的影响。方法选择2017年1月至2019年3月唐山市人民医院神经外科收治的76例急性脑梗死患者为研究对象,根据治疗方法不同分为对照组(n=38)和观察组(n=38)。对照组采用静脉溶栓治疗,注射用阿替普酶0.9 mg/kg,最大剂量不超过90 mg,先将总剂量10%静脉推入,剩余90%剂量在1 h内静脉滴注。观察组在对照组的基础上联合rt-PA静脉溶栓治疗,金纳多注射液70 mg+0.9%氯化钠溶液250 m L,静脉滴注,每日3次;两组连续治疗2周。比较两组患者的临床疗效,治疗前后美国国立卫生研究院卒中量表(NIHSS)、改良RANKIN量表(mRS)评分,血清炎症因子[高敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)及白细胞介素-8(IL-8)]以及血液流变学(血浆黏度、纤维蛋白原、血细胞比容)。结果观察组总有效率高于对照组[78.95%(30/38)比55.26%(21/38)](P<0.05)。治疗后两组患者NIHSS、mRS评分低于治疗前,观察组低于对照组(P<0.05),两组间比较差异无统计学意义(P>0.05),时点间、组间和时点间交互作用比较差异有统计学意义(P<0.05)。治疗后两组血清炎症因子(hs-CRP、TNF-α及IL-8)和血液流变学(血浆黏度、纤维蛋白原、血细胞比容)水平均低于治疗前,观察组低于对照组(P<0.05),两组间比较差异无统计学意义(P>0.05),时点间、组间和时点间交互作用比较差异有统计学意义(P<0.05)。结论金纳多注射液联合rt-PA静脉溶栓治疗急性脑梗死的效果显著,可减轻神经功能缺损程度,抑制血清炎症因子水平。
Objective To analyze the effects of Ginaton injection combined with recombinant tissue plasminogen activator(rt-PA) intravenous thrombolysis on neurological deficits and serum factors in patients with acute cerebral infarction.Methods A total of 76 patients with acute cerebral infarction admitted to the Department of Neurosurgery,Tangshan City People’s Hospital from Jan.2017 to Mar.2019 were enrolled in the study.They were divided into a control group(n = 38)and an observation group(n = 38) according to different treatment methods.The control group received intravenous thrombolytic therapy: injection of alteplase 0.9 mg/kg,the maximum not exceeding 90 mg,10% of the total was intravenously injected first,and the remaining 90% of the dose was intravenously infused within one hour.The observation group was treated with Ginaton injection combined with rt-PA intravenous thrombolysis,on basis of the control group’s regimen: Ginaton injection 70 mg + 0.9% sodium chloride solution 250 m L,intravenous infusion,3 times daily;both groups were treated continuously for 2 weeks.The National Institutes of Health Stroke scale(NIHSS),modified RANKIN scale(mRS) score,serum inflammatory factors[high sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-8(IL-8)]and hemorheology(plasma viscosity,fibrinogen,specific volume of blood cells),which indicated the clinical efficacy,were compared between the two groups.Results The total effective rate in the observation group was higher than that in the control group[78.95%(30/38) vs 55.26%(21/38)](P<0.05).After treatment,the NIHSS,mRS score of the two groups were lower than those before treatment,and that of the observation group was lower than that of the control group.There was no significant difference between the two groups(P>0.05);while there were significant differences between time points and interactions of groups and time points(P<0.05).After treatment,the levels of serum inflammatory factors(hs-CRP,TNF-α and IL-8) and hemorheology(plasma viscosity,fibrinogen,hematocrit) in the two groups were lower than those before treatment,while those in the observation group were lower than those in the control group(P <0.05).There was no significant difference between the two groups(P>0.05),while there were significant differences between time points and interactions of groups and time points(P<0.05).Conclusion rt-PA intravenous thrombolysis combined with Ginaton injection is signficantly effective in the treatment of acute cerebral infarction,which can reduce the degree of neurological deficit and inhibit the level of serum inflammatory factors.
作者
辛佳
赵喜庆
张利
孙明阳
石文建
XIN Jia;ZHAO Xiqing;ZHANG Li;SUN Mingyang;SHI Wenjian(Department of Neurosurgery,Tangshan People′s Hospital,Tangshan 063000,China)
出处
《医学综述》
2019年第19期3949-3952,F0003,共5页
Medical Recapitulate
关键词
急性脑梗死
重组组织型纤溶酶原激活物
静脉溶栓
金纳多注射液
神经功能缺损
血清炎症因子
Acute cerebral infarction
Recombinant human tissue type plasminogen activator
Intravenous thrombolysis
Ginaton injection
Neurological deficit
Serum inflammatory factor
