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芬戈莫德联合阿替普酶治疗急性缺血性脑卒中的疗效及康复护理

Efficacy of fingolimod combined with alteplase in acute ischemic stroke and rehabilitation nursing.

作者信息

Liantao Zhang, Jing Zhang, Lingling Lu, Hua Li

机构信息

Office, Jinan Zhangqiu District Hospital of TCM, Jinan, Shandong, China.

Second Internal Medicine, Jinan Zhangqiu District Hospital of TCM, Jinan, Shandong, China.

出版信息

Pak J Pharm Sci. 2019 Jan;32(1(Special)):413-419.

PMID:30852478
Abstract

This paper aims to observe and analyze the safety and clinical efficacy of Fingolimod combined with alteplase intravenous thrombolysis in the treatment of acute ischemic stroke. 90 patients with acute ischemic stroke were randomly divided into two groups. 45 patients in the control group were given alteplase intravenous thrombolysis for injection. 45 cases in the trial group were treated with Fingolimod combined with alteplase. There was no significant difference in NIHSS score, mRS score and BI index between the two groups 14 days after treatment, but 90 days after treatment, NIHSS score and mRS score of the experimental group were significantly lower than that of the control group, and BI index was significantly higher (P<0.05). 24 hours after oral administration of Fingolimod (0.5 mg), the circulating blood CD4 + T, CD8 + T, CD19 + B and CD56 + natural killer cells of the patients in the combined treatment group decreased steadily to varying degrees. The results confirm the pharmacological effect of Fingolimod: it changes lymphocyte migration, promotes lymphocyte to enter lymphoid tissue, prevents lymphocyte from leaving lymphoid tissue to enter the peripheral circulation, and thus prevents these immune cells from infiltrating the central nervous system. The results showed that Fingolimod combined with alteplase intravenous thrombolysis is safe for patients with acute ischemic stroke. .

摘要

本文旨在观察和分析芬戈莫德联合阿替普酶静脉溶栓治疗急性缺血性脑卒中的安全性及临床疗效。将90例急性缺血性脑卒中患者随机分为两组。对照组45例给予阿替普酶静脉注射溶栓治疗。试验组45例采用芬戈莫德联合阿替普酶治疗。治疗14天后,两组患者的美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分及巴氏指数(BI)差异无统计学意义,但治疗90天后,试验组NIHSS评分和mRS评分显著低于对照组,BI指数显著高于对照组(P<0.05)。口服芬戈莫德(0.5 mg)24小时后,联合治疗组患者外周血中CD4+T、CD8+T、CD19+B及CD56+自然杀伤细胞均有不同程度的下降。结果证实了芬戈莫德的药理作用:它改变淋巴细胞迁移,促使淋巴细胞进入淋巴组织,阻止淋巴细胞离开淋巴组织进入外周循环,从而防止这些免疫细胞浸润中枢神经系统。结果表明,芬戈莫德联合阿替普酶静脉溶栓治疗急性缺血性脑卒中患者是安全的。

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