摘要
目的探讨Solitaire支架治疗急性缺血性脑卒中(acute ischemic stroke,AIS)患者的疗效及血清因子、认知功能、并发症的影响。方法选择2017年1月—2019年11月于武汉科技大学医学院接受的Solitaire或微导管机械碎栓术治疗的120例AIS患者为研究对象,将研究对象分为对照组和观察组,每组60例。对照组采用微导管机械碎栓术联合溶栓治疗,观察组采用Solitaire支架治疗。比较两组治疗前、术后72 h血清神经元特异性烯醇化酶(neuron specific enolase,NSE)、S100-β蛋白(S100-βprotein,S100-β)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、细胞白介素-6(interleukin-6,IL-6)、术后90 d美国国立卫生研究院卒中量表(NIH Stroke Scale,NIHSS)评分、蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)评分、临床疗效及术后并发症情况。结果治疗前,两组血清NSE、S100-β、TNF-α、IL-6水平、NIHSS评分、MoCA评分比较差异均无统计学意义(P均>0.05);术后72 h,两组NSE、S100-β、TNF-α、IL-6均降低(P均<0.001);术后3个月,两组NIHSS评分均降低,MoCA评分均升高(P均<0.001);观察组术后72 h NSE、S100-β、TNF-α、IL-6均低于对照组,术后3个月NIHSS评分低于对照组,MoCA评分高于对照组(P均<0.05);观察组预后良好率高于对照组(P<0.05);两组术后继发脑出血、脑栓塞、再灌注损伤、脑卒中进展等临床并发症比较差异无统计学意义(P均>0.05)。结论Solitaire支架取栓预后良好,可降低AIS患者血清NSE、S100-β、TNF-α、IL-6等水平,改善神经缺损程度及认知功能,临床疗效满意,安全性高,值得临床应用和推广。
Objective To explore the therapeutic effect of Solitaire stent in the treatment of acute ischemic stroke(AIS)and the influence of serum factors,cognitive function and complications.Methods Totally 120 patients with AIS who were treated by Solitaire or mechanical micro catheter thrombectomy in Medical College of Wuhan University of Science and Technology from January 2017 to November 2019 were selected as the study objects.The patients were divided into control group and observation group,with 60 cases in each group.The control group was treated by mechanical thrombolysis with microcatheter,while the observation group was treated by solid stent.The serum factors(NSE,S100-β,TNF-α,IL-6)before and 72 h after treatment,NIHSS score,MoCA score,clinical efficacy and postoperative complications were compared between the two groups.Results Before the treatment,there was no significant difference in serum NSE,S100-β,TNF-α,IL-6,NIHSS score and MoCA score between the two groups(P all>0.05).72 h after the operation,NSE,S100-β,TNF-α,IL-6 were all decreased in the two groups(P all<0.001);90 d after the operation,NIHSS score and MoCA score were all decreased in the two groups(P all<0.001).72 h after the operation in the observation group NSE,S100-β,TNF-α,IL-6 were lower than the control group,90 d after the operation,NIHSS score was lower than the control group,MoCA score was higher than the control group(P all<0.05).The good prognosis rate of the observation group was higher than the control group(P<0.05).There was no significant difference between the two groups in the clinical complications such as secondary cerebral hemorrhage,cerebral embolism,reperfusion injury,stroke progress(P all>0.05).Conclusion Solitaire stent can significantly reduce the levels of serum NSE,S100-β,TNF-αand IL-6 in AIS patients,improve the degree of nerve defect and cognitive function,with satisfactory clinical effect and high safety,which is worthy of clinical application and promotion.
作者
刘子雄
朝浩
程桂荣
LIU Zixiong;CHAO Hao;CHENG Guirong(School of Medicine,Wuhan University of Science and Technology,Wuhan 430050,China;Department of Neurology,Hanyang Hospital,Wuhan 430050,China)
出处
《宁夏医科大学学报》
2021年第5期502-507,共6页
Journal of Ningxia Medical University
