摘要
目的探究数字减影血管造影(DSA)引导下神经介入联合动静脉溶栓治疗急性缺血性脑卒中(AIS)的效果及对脂蛋白相关磷脂酶A2(Lp-PLA2)、泛素羧基末端水解酶L1(UCH-L1)、β-淀粉样蛋白1-42(Aβ1-42)的水平影响。方法选择2017年7月至2021年9月我院收治的80例AIS患者作为研究对象,根据治疗方案不同将其分为对照组与观察组,每组40例。对照组接受静脉溶栓治疗,观察组接受DSA引导下神经介入联合动静脉溶栓治疗。比较两组的治疗效果。结果观察组的血管再通率为77.50%,高于对照组的40.00%,差异具有统计学意义(P<0.05)。治疗后,两组的Lp-PLA2、UCH-L1、Aβ1-42水平均低于治疗前,且观察组低于对照组,差异具有统计学意义(P<0.05)。治疗后,两组的脑血管最小血流速度(Vmin)、动态阻抗(DR)均高于治疗前,脉搏波速(Wv)、外周阻力(R)均低于治疗前,且观察组优于对照组,差异具有统计学意义(P<0.05)。观察组的不良事件总发生率为7.50%,明显低于对照组的27.50%,差异具有统计学意义(P<0.05)。治疗后,两组的美国国立卫生研究院卒中量表(NIHSS)评分均低于治疗前,日常生活活动能力量表(ADL)评分均高于治疗前,且观察组优于对照组,差异具有统计学意义(P<0.05)。结论DSA引导下神经介入联合动静脉溶栓治疗AIS不仅能调节Lp-PLA2、UCH-L1、Aβ1-42表达,改善脑血管血流动力学指标水平,还能提高血管再通率,降低不良事件总发生率,利于神经功能恢复,值得推广及应用。
Objective To explore the effects of digital subtraction angiography(DSA)-guided neurological intervention combined with arterial and intravenous thrombolysis in the treatment of acute ischemic stroke(AIS)and its influences on lipoprotein-associated phospholipase A2(Lp-PLA2),ubiquitin carboxy terminal hydrolase L1(UCH-L1),β-amyloid protein 1-42(Aβ1-42)levels.Methods A total of 80 AIS patients admitted in our hospital from July 2017 to September 2021 were selected as the research objects,and the patients were divided into control group and observation group according to different treatment schemes,with 40 cases in each group.The control group was treated with intravenous thrombolysis,and the observation group was treated with DSA-guided neurological intervention combined with arterial and intravenous thrombolysis.The therapeutic effects of the two groups were compared.Results The vascular recanalization rate in the observation group was 77.50%,which was higher than 40.00%in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of Lp-PLA2,UCH-L1 and Aβ1-42 in the two groups were lower than those before treatment,and those in the observation group were lower than the control group,the differences were statistically significant(P<0.05).After treatment,the minimum blood flow velocity(Vmin)and dynamic impedance(DR)in the two groups were higher than those before treatment,and the pulse wave velocity(Wv)and peripheral resistance(R)were lower than those before treatment,and those in the observation group were better than the control group,the differences was statistically significant(P<0.05).The total incidence of adverse events in the observation group was 7.50%,which was significantly lower than 27.50%in the control group,and the difference was statistically significant(P<0.05).After treatment,the National Institutes of Health Stroke Scale(NIHSS)score in the two groups was lower than that before treatment,the Activity of Daily Living Scale(ADL)score was higher than that before treatment,and those in the observation group were better than the control group,the differences were statistically significant(P<0.05).Conclusion DSA-guided neurological intervention combined with arterial and intravenous thrombolysis in the treatment of AIS can not only regulate the expression of Lp-PLA2,UCH-L1 and Aβ1-42,improve the levels of cerebrovascular hemodynamic indexes,but also improve the vascular recanalization rate and reduce the total incidence of adverse events,which is conducive to the recovery of neurological function and is worthy of promotion and application.
作者
杨杰
翟海燕
YANG Jie;ZHAI Haiyan(No.215 Hospital of Shaanxi Nuclear Industry,Xianyang 712000,China)
出处
《临床医学研究与实践》
2022年第32期49-52,90,共5页
Clinical Research and Practice
关键词
数字减影血管造影
动静脉溶栓
急性缺血性脑卒中
神经功能
血流动力学指标
digital subtraction angiography
arterial and intravenous thrombolysis
acute ischemic stroke
nerve function
cerebrovascular hemodynamic index
