摘要
目的探讨阿替普酶对45-65岁组和66-80岁组急性脑梗死(ACI)患者的溶栓效果及对血清神经元特异性烯醇化酶(NSE)、S100β蛋白(S100β)、溶血磷脂酸(LPA)水平的影响。方法选取湖北省赤壁市中医医院脑病科采用阿替普酶溶栓治疗的82例ACI患者为研究对象,根据年龄差异分为45~65岁组(37例)和66~80岁组(45例)。对比两组临床疗效及不良反应情况,观察阿替普酶溶栓对两组患者美国州立卫生研究院脑卒中(NIHSS)评分、改良RANKIN评分(mRS)的影响,对比两组血清NSE、S100β、LPA水平差异。结果45~65岁组治疗总有效率为91.89%,明显高于66~80岁组80.00%(P<0.05);45~65岁组注射点出血、牙龈出血以及皮肤黏膜出血发生率显著低于66~80岁组(P<0.05);治疗后2w,两组患者NIHSS评分、mRS评分及血清NSE、S100β、LPA水平均明显降低(P<0.05),且45~65岁组均显著低于66~80岁组(P<0.05)。结论阿替普酶对45~65岁ACI患者的疗效优于66~80岁患者,可有效改善患者神经功能状况和降低血清NSE、S100β、LPA水平。
Objective To explore the thrombolytic effect of alteplase on differently-aged patients with acute cerebral infarction(ACI)and the effects on serum neuronspecific enolase(NSE),S100[3,lysophosphatidic acid(LPA).Methods 82 ACI patients treated with alteplase thrombolysis in our hospital were selected as the study subjects.According to the age,they were divided into the 45-65 years group(37 cases)and the 66-80 years group(45 cases).The clinical efficacy and adverse reactions of two groups were compared,and the effects of alteplase thrombolysis on the cerebral apoplexy(NIHSS)score and Modified RANKIN Scale(mRS)were observed.Serum NSE,S100 and LPA levels were compared between the two groups.Results The total effective rate was 91.89%in 45-65 years group,which was significantly higher than 80.00%in 66-80 years group(P<0.05).The incidence of injection point bleeding,gingival bleeding and skin mucosal bleeding in 45-65 years group was significantly lower than that in 66-80 years group(P<0.05).At 2 w after treatment,the NIHSS score,mRS score,serum NSE,S100 and LPA levels in two groups were significantly reduced(P<0.05),and the levels in 45-65 years group were significantly lower than 66-80 years group(P<0.05).Conclusion The efficacy of alteplase in the treatment of 45-65 years ACI patients is better than 66-80 years patients.It can effectively improve the neurological status and reduce the levels of serum NSE,S100 and LPA.
作者
王晓宏
毛善平
Wang Xiaohong;Mao Shanping(Department of Encephalopathy,the Chibi Hospital of Traditional Chinese Medicine,Hubei 437300,China)
出处
《脑与神经疾病杂志》
CAS
2021年第4期214-218,共5页
Journal of Brain and Nervous Diseases
基金
湖北省自然科学基金(2017CBD0282)。
