摘要
目的观察阿替普酶静脉溶栓治疗急性脑梗死的临床疗效,并探讨其对患者血清神经元特异性烯醇化酶(NSE)、中枢神经特异性蛋白(S-100β)及神经生长因子(NGF)的影响,为临床诊疗提供参考依据。方法选取2017年1月至2018年1月商洛市中心医院急诊医学科治疗的急性脑梗死患者100例进行研究,采用随机数表法分为观察组和对照组,每组50例。观察组采用阿替普酶静脉溶栓治疗,对照组采用尿激酶溶栓治疗,一周一个疗程,均治疗两个疗程。比较两组患者的治疗效果、治疗前、治疗后2周的血清NSE、S-100β、NGF、白细胞介素-6(IL-6)、血清肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平以及治疗期间的不良反应发生情况。结果观察组患者的治疗总有效率为94.0%,明显高于对照组的78.0%,差异有统计学意义(P<0.05);治疗前,两组患者的NSE、S-100β、NGF水平比较差异均无统计学意义(P>0.05);治疗后,观察组患者的NSE、S-100β水平为(11.48±2.10)μg/L、(1.21±0.21)μg/L,明显低于对照组的(14.28±2.31)μg/L、(1.48±0.22)μg/L,NGF为(118.12±10.45)ng/L,明显高于对照组的(105.68±10.21)ng/L,差异均有统计学意义(P<0.05);治疗前,两组患者的IL-6、TNF-α、CRP水平比较差异均无统计学意义(P>0.05);治疗后,观察组患者的IL-6、TNF-α、CRP水平分别为(11.21±1.32)ng/L、(28.12±4.10)ng/L、(3.85±0.57)mg/L,明显低于对照组的(13.28±1.45)ng/L、(35.28±4.30)ng/L、(4.98±0.87)mg/L,差异均有统计学意(P<0.05);观察组患者治疗期间的不良反应发生率为8.0%,略低于对照组的14.0%,但差异无统计学意义(P>0.05)。结论阿替普酶静脉溶栓治疗急性脑梗死效果显著,其可有效降低患者的血清NSE、S-100β水平,改善患者神经功能,抑制炎症反应,安全性高,值得临床推广使用。
Objective To observe the clinical effect of intravenous thrombolysis with ateplase in the treatment of acute cerebral infarction,and to explore its effect on serum neuron-specific enolase(NSE),S-100β,and nerve growth factor(NGF),so as to provide reference for clinical diagnosis and treatment.Methods One hundred patients with acute cerebral infarction were selected from Department of Emergency Medicine,Shangluo Central Hospital from January 2017 to January 2018.Using random number table method,the patients were divided into observation group and control group,with 50 patients in each group.The observation group was treated by intravenous thrombolysis with ateplase,while the control group was treated by urokinase,for 2 courses of treatment.The therapeutic effect,serum NSE,S-100β,NGF,interleukin-6(IL-6),serum tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),and adverse reactions during the treatment were compared between the two groups.Results The total effective rate of the observation group was 94.0%,which was significantly higher than 78.0% of the control group(P<0.05).Before treatment,there was no significant difference in the levels of NSE,S-100β,and NGF between the two groups of patients(P>0.05).After treatment,the levels of NSE and S-100βin the observation group were(11.48±2.10)μg/L,(1.21±0.21)ng/L,which were significantly lower than(14.28±2.31)ng/L,(1.48±0.22)μg/L,and NGF was(118.12±10.45)ng/L,which was significantly higher than(105.68±10.21)ng/L of the control group(P<0.05).Before treatment,the levels of IL-6,TNF-α,and CRP in the two groups had no significant difference(P>0.05).After treatment,the levels of IL-6,TNF-α,and CRP in the observation group were(11.21±1.32)ng/L,(28.12±4.10)μg/L,(3.85±0.57)mg/L,significantly lower than(13.28±1.45)ng/L,(35.28±4.30)μg/L,(4.98±0.87)mg/L in the control group(P<0.05).The incidence of adverse reactions was 8.0%in the observation group,slightly lower than 14.0% in the control group(P>0.05).Conclusion Intravenous thrombolysis with ateplase can effectively reduce the serum NSE and S-100βlevels in patients with acute cerebral infarction,improve the neurological function of patients,inhibit inflammatory response,and have high safety,which is worthy of clinical application.
作者
徐瑰翎
万治平
廖涛
XU Gui-ling;WAN Zhi-ping;LIAO Tao(Department of Emergency Medicine,Shangluo Central Hospital,Shangluo 726000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2020年第8期962-965,共4页
Hainan Medical Journal
关键词
急性脑梗死
阿替普酶
神经元特异性烯醇化酶
综中枢神经特异性蛋白
神经生长因子
疗效
Acute cerebral infarction
Ateplase
Neuron specific enolase
Comprehensive central nervous system specific protein
Nerve growth factor
Therapeutic effect
作者简介
通讯作者:徐瑰翎,E-mail:xugl-0074@163.com。
