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阿替普酶联合丁苯酞治疗急性缺血性脑卒中的临床观察
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| 篇名： | 阿替普酶联合丁苯酞治疗急性缺血性脑卒中的临床观察 |
| TITLE： | |
| 摘要： | 目的：探讨阿替普酶联合丁苯酞治疗急性缺血性脑卒中的临床疗效及安全性。方法：选取我院收治的急性缺血性脑卒中患者98例，按照随机数字表法分为观察组和对照组，各49例。对照组患者在控制血糖、血压等常规治疗基础上给予丁苯酞氯化钠注射液100 ml，ivgtt，bid；观察组患者在对照组基础上给予注射用阿替普酶5 mg加入0.9％氯化钠注射液（NS）10 ml中，iv+注射用阿替普酶45 mg加入NS 100 ml中，ivgtt，qd。两组患者治疗时间均为2周。观察两组患者临床疗效及治疗前后脑梗死面积、美国国立卫生研究院卒中量表（NIHSS）评分、生活能力评分、白细胞介素（IL）-6、IL-8、IL-10、C反应蛋白（CRP）、24 h尿蛋白定量、血肌酐（Scr）和肌酐清除率水平，并记录不良反应发生情况。结果：观察组患者1例、对照组患者2例因重度出血而退出本研究。观察组患者治疗总有效率（95.83％）明显高于对照组（80.85％），差异有统计学意义（P＜0.05）。治疗前，两组患者上述指标比较，差异均无统计学意义（P＞0.05）。治疗后，观察组患者脑梗死面积、NIHSS评分明显缩小或降低，生活能力评分明显升高，且观察组改善程度均明显优于对照组，差异均有统计学意义（P＜0.05）；观察组患者24 h尿蛋白定量、Scr均明显低于对照组，差异均有统计学意义（P＜0.05）；观察组患者治疗1周后IL-6水平及治疗2周后IL-6、IL-8、IL-10和CRP水平明显低于对照组，差异均有统计学意义（P＜0.05）。两组患者的总不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：阿替普酶联合丁苯酞治疗急性缺血性脑卒中疗效显著，能有效降低患者的血清炎症因子水平，控制脑组织缺血和梗死面积，改善患者神经功能，并保护其肾功能。 |
| ABSTRACT： | OBJECTIVE： To discuss clinical efficacy and safety of alteplase combined with butylphthalide to the patients with acute ischemic stroke. METHODS： 98 patients with acute ischemic stroke in our hospital were selected and divided into observation group and control group according to random number table， with 49 patients in each group. Control group was additionally given Butylphthalide and sodium chloride injection 100 ml， ivgtt，bid， on the basis of routine treatment as controlling blood glucose， blood pressure， etc.； observation group additionally received Alteplase for injection 5 mg added into NS 10 ml， iv+ Alteplase for injection 45 mg added into NS 100 ml， ivgtt， qd， on the basis of control group. Both groups were treated for 2 weeks. Clinical efficacies of 2 groups were compared as well as cerebral infarction area， NIHSS score， ability score of daily living， the levels of IL-6， IL-8， IL-10， CRP， 24 h urine protein， Scr and creatinine clearance rate before and after treatment. The occurrence of ADR was also recorded. RESULTS： 1 patient of observation group and 2 patients of control group withdrew from the study due to severe hemorrhage. Total effective rate of observation group （95.83％） was significantly higher than that of control group （80.85％）， with statistical significance （P＜0.05）. Before treatment， there was no statistical significance in above indexes between 2 groups （P＞0.05）. The cerebral infarction area and NIHSS score were reduced significantly in observation group after treatment， ability score of daily living were increased significantly in observation group after treatment， and the improvement of observation group was significantly better than control group， with statistical significance （P＜0.05）. 24 h urine protein and Scr of observation group was significantly lower than those of control group， with statistical significance （P＜0.05）. the level of IL-6 in observation group 1 week after treatment and the levels of IL-6， IL-8， IL-10 and CRP 2 weeks after treatment were significantly lower than in control group， with statistical significance （P＜0.05）. There was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： Alteplase combined with butylphthalide show significant therapeutic efficacy， can effectively reduce the level of serum inflammatory factors， control brain tissue ischemia and cerebral infarction area， and improve neurologic function and protect renal function in patients with acute ischemic stroke. |
| 期刊： | 2016年第27卷第35期 |
| 作者： | 赵晶，赵辉，孔文基，张艳国 |
| AUTHORS： | ZHAO Jing，ZHAO Hui，KONG Wenji，ZHANG Yanguo |
| 关键字： | 阿替普酶；丁苯酞；急性缺血性脑卒中；血清炎症因子；肾功能 |
| KEYWORDS： | Alteplase； Butylphthalide； Acute ischemic stroke； Serum inflammatory factors； Renal function |
| 阅读数： | 516 次 |
| 本月下载数： | 1 次 |
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