贵州医科大学学报

2020, v.45;No.243(12) 1484-1488

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丁苯酞联合阿替普酶静脉溶栓治疗对急性脑梗死患者神经功能和日常生活能力的影响
Effects of Intravenous Thrombolytic Therapy with Butylphthalide and Alteplase on Neurological Function and Activity of Daily Living in Acute Cerebral Infarction

吕虎;范从华;王晓伟;
LV Hu;FAN Conghua;WANG Xiaowei;Emergency Room,Xichang People's Hospital;Emergency Room,the 1stPeople's Hospital of Chengdu;

摘要(Abstract):

目的:探讨丁苯酞联合阿替普酶静脉溶栓治疗对急性脑梗死(ACI)患者神经功能缺损及日常生活能力的影响。方法:选取ACI患者,经倾向性匹配评分后分为治疗组和对照组各51例;治疗组患者在常规处理基础上,予以丁苯酞联合急诊阿替普酶静脉溶栓治疗,对照组患者予以常规治疗及阿替普酶静脉溶栓,连续用药14 d后评价治疗效果;比较两组治疗前、治疗后第1、7、14天用美国国立卫生研究院卒中量表(NIHSS)评价患者的神经功能缺损、用Barthel指数评价患者的日常生活能力;治疗14 d时,比较两组患者血清中枢神经特异性蛋白(S-100β)、神经元特异性烯醇化酶(NSE)等脑神经损伤指标,记录两组患者用药期间药物不良反应。结果:治疗后第1、7、14天时,治疗组NIHSS评分均显著低于对照组、差异有统计学意义(P <0. 05),Barthel指数均高于对照组,差异有统计学意义(P <0. 05);治疗14 d时,治疗组总有效率98. 04%,显著高于对照组的82. 35%,差异有统计学意义(P <0. 05),治疗组血清S-100β、NSE水平均显著低于对照组(P <0. 05);治疗组与对照组不良反应发生率分别为15. 69%、7. 84%,两组比较差异无统计学意义(P> 0. 05)。结论:丁苯酞联合阿替普酶静脉溶栓用于ACI患者治疗,有利于改善患者神经功能缺损、促进日常生活能力恢复、提高临床疗效,且安全性较好。
Objective: To investigate the effects of intravenous thrombolytic therapy with Butylphthalide combined with Alteplase on neurological deficits and activity of daily living in patients with acute cerebral infarction( ACI). Methods: Patients with ACI were selected and assigned to treatment group and control group in equal number( n = 51) according to propensity matching score.In addition to routine treatment,treatment group was given intravenous thrombolytic therapy with Butylphthalide combined with emergency Alteplase,and control group was given routine treatment and Alteplase intravenous thrombolysis. The treatment effects were evaluated after 14 d of continuous medication. National Institutes of Health Stroke Scale( NIHSS) was adopted to evaluate the neurological deficits,and barthel index was used to assess the activity of daily living before treatment and 1,7,and 14 d after treatment. On the 14 thd of treatment,cerebral nerve injury indicators of serum central nerve specific protein( S-100β) and neuron specific enolase( NSE) of both groups were compared,and the adverse reactions during medication were recorded. Results: On 1 st,7 thand 14 thd of treatment,the NIHSS score of treatment group was significantly lower than that of control group,differences were statistically significant( P < 0. 05),and the Barthel index of treatment group was significantly higher than that of control group,differences were statistically significant( P < 0. 05). 14 d after treatment,the total effective rate of treatment group was significantly higher than that of control group( 98. 04% vs 82. 35%),differences were statistically significant( P < 0. 05). The levels of serum S-100β and NSE of treatment group were significantly lower than those of control group( P <0. 05). The incidence rate of adverse reactions for treatment group and control group was 15. 69% and7. 84% respectively, differences were not statistically significant( P > 0. 05). Conclusion:Intravenous thrombolytic therapy with Butylphthalide combined with Alteplase for patients with ACI is beneficial to improve neurological deficits,promote recovery of activity of daily living and enhance the clinical efficacy.

关键词(KeyWords): 组织型纤溶酶原激活物;急性脑梗死;静脉溶栓;丁苯酞;神经功能;日常生活能力
tissue plasminogen activator;acute cerebral infarction(ACI);intravenous thrombolysis;butylphthalide;neurological function;activity of daily living

Abstract:

Keywords:

基金项目(Foundation): 凉山州技术研究开发与推广应用项目(19YYJS0091)

作者(Author): 吕虎;范从华;王晓伟;
LV Hu;FAN Conghua;WANG Xiaowei;Emergency Room,Xichang People's Hospital;Emergency Room,the 1stPeople's Hospital of Chengdu;

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DOI: 10.19367/j.cnki.2096-8388.2020.12.023

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