摘要
目的探讨阿替普酶静脉溶栓前应用依达拉奉对急性脑梗死患者的疗效及脑出血转化的影响。方法收集2018年2月至2019年10月崇州市人民医院治疗的急性脑梗死患者100例,将其按随机表法分为观察组与对照组,各50例。观察组给以阿替普酶溶栓前联合应用依达拉奉治疗,对照组单独使用阿替普酶溶栓治疗。2组患者均于溶栓后继续给予依达拉奉治疗。比较2组患者溶栓前、溶栓后即刻、溶栓后24 h和溶栓后7天的美国国立卫生研究院卒中量表(NIHSS)评分;溶栓前和溶栓后24 h血浆D-二聚体和超敏C反应蛋白(hs-CRP)水平;外周血miRNA-24和miRNA-223表达;溶栓后10天和溶栓后90天改良Rankin量表(mRS)评分;溶栓后24 h脑出血转化率。结果2组患者溶栓后即刻、24 h和7天NIHSS评分较溶栓前降低(P均<0.05);观察组溶栓后即刻、24 h和7天NIHSS评分低于对照组(P均<0.05)。2组溶栓后24 h血浆D-二聚体和hs-CRP水平较溶栓前降低(P<0.05);观察组溶栓后24 h血浆D-二聚体和hs-CRP水平低于对照组(P<0.05)。2组溶栓后24 h外周血miRNA-24表达升高,而miRNA-223表达降低;观察组溶栓后24 h外周血miRNA-24表达高于对照组,而miRNA-223表达低于对照组(P<0.05)。观察组溶栓后10天和溶栓后90天mRS评分低于对照组(P<0.05)。2组溶栓后24 h脑出血转化率比较,差异无统计学意义(P>0.05)。结论阿替普酶静脉溶栓前应用依达拉奉对急性脑梗死患者的疗效良好,可降低脑出血转化,且可上调miRNA-24表达和下调miRNA-223表达。
ObjectiveTo investigate the efficacy of edaravone before intravenous thrombolysis with alteplase in patients with acute cerebral infarction and the impact on the transformation of cerebral hemorrhage.MethodsA total of 100 patients with acute cerebral infarction at Chongzhou People's Hospital from February 2018 to October 2019 were collected,and they were randomly divided into an observation group and a control group,with 50 cases in each group.The observation group was treated with alteplase combined with edaravone before thrombolysis,and the control group was treated with alteplase alone.Both groups continued to be treated with edaravone after thrombolysis.We compared National Institutes of Health Stroke Scale(NIHSS)scores before thrombolysis,immediately after thrombolysis,24 hours after thrombolysis,and 7 days after thrombolysis;plasma D-dimer and high sensitive C-reactive protein(hs-CRP)levels;and the expression of miRNA-24 and miRNA-223 in peripheral blood before and 24 hours after thrombolysis;modified Rankin scale(mRS)scores at 10 and 90 days after thrombolysis;and the transformation rate of cerebral hemorrhage 24 h after thrombolysis between the two groups.ResultsThe NIHSS scores immediately,24 h,and 7 days after thrombolysis were significantly lower than those before thrombolysis in both groups(P<0.05 each);the NIHSS scores of the observation group immediately,24 h,and 7 days after thrombolysis were significantly lower than those of the control group(P<0.05 each).The plasma D-dimer and hs-CRP level at 24 h after thrombolysis were significantly lower than those before thrombolysis in both groups(P<0.05);the plasma D-dimer and hs-CRP levels at 24 h after thrombolysis were significantly lower than those of the control group(P<0.05).The expression of miRNA-24 in peripheral blood at 24 h after thrombolysis was increased in both groups,while the expression of miRNA-223 was decreased;the changes in the expression of miRNA-24 and miRNA-223 in peripheral blood were more significant in the observation group than in the control group(P<0.05).The mRS scores at 10 and 90 days after thrombolysis were significantly lower in the observation group than in the control group(P<0.05).There was no significant difference in intracerebral hemorrhage transformation of the two groups at 24 h after thrombolysis(P>0.05).ConclusionEdaravone before intravenous thrombolysis of alteplase has good efficacy in patients with acute cerebral infarction,and can reduce the transformation of cerebral hemorrhage,up-regulate the expression of miRNA-24,and down-regulate the expression of miRNA-223.
作者
吴有林
祝秀蓉
梁世福
吴文斌
Wu Youlin;Zhu Xiurong;Liang Shifu;Wu Wenbin(Department of Neurology,Chongzhou people's Hospital,Chongzhou 611230,China;Department of Neurology,Sichuan Provincial People's Hospital,Sichuan Academy of Medical Sciences,Chengdu 610072,China)
出处
《中华临床医师杂志（电子版）》
CAS
北大核心
2021年第12期928-932,共5页
Chinese Journal of Clinicians(Electronic Edition)
基金
四川省卫健委科研课题项目(18PJ338)
关键词
阿替普酶
静脉溶栓
依达拉奉
急性脑梗死
疗效
脑出血转化
Alteplase
Intravenous thrombolysis
Edaravone
Acute cerebral infarction
Curative effect
Transformation of cerebral hemorrhage
作者简介
通信作者:吴文斌,Email:wwb9925h@163.com
