静脉溶栓联合轻度低温治疗急性脑梗死
Intravenous thrombolysis in combination with mild hypothermia therapy in the treatment of acute cerebral infarction.
作者信息
Liu Xiaoying, Rao Shengli, Wang Jiajia
机构信息
Xiaoying Liu Departments of Neurology, Binzhou People's Hospital, Shandong, 256610, China.
Shengli Rao Departments of Emergency, Binzhou People's Hospital, Shandong, 256610, China.
出版信息
Pak J Med Sci. 2019 Jul-Aug;35(4):1161-1166. doi: 10.12669/pjms.35.4.311.
OBJECTIVE
To investigate the efficacy of recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis in combination with mild hypothermia therapy in the treatment of acute cerebral infarction.
METHODS
One hundred and thirty-two patients with acute cerebral infarction who were admitted to our hospital were selected and grouped into a control group and an observation group, 66 each group. Patients in the control group were given conventional treatment in combination with local mild hypothermia therapy, and patients in the observation group were given rt-PA intravenous thrombolysis on the basis of conventional treatment and local mild hypothermia therapy. National institute of health stroke scale (NIHSS) score and intracranial pressure (ICP) of the two groups before and after treatment was recorded. The efficacy of the two groups was evaluated. The modified Rankin scale (MRS) score was followed up for three months. The blood samples of the patients were collected before and after thrombolysis. Superoxide dismutase (SOD) and malondialdehyde (MDA) levels in the plasma were detected.
RESULTS
The NIHSS score of the two groups decreased in the 1, 3 and 7 day after treatment compared to before treatment (p<0.05), but the NIHSS score of the two groups had no significant difference at different time points after treatment (p>0.05). The ICP of the two groups decreased in the 1, 3 and 7 day after treatment compared to before treatment (p<0.05), and the decrease of ICP of the observation group was more significant than that of the control group at the same time point (1, 3 and 7 day after treatment) (p<0.05). The clinical efficacy of the observation group was higher than that of the control group after treatment, and the difference was statistically significant (p<0.05). The MDA concentration of both groups decreased at different time points after treatment (p<0.05), but the SOD concentration increased (p<0.05). The MDA concentration of the observation group was lower than that of the control group at different time points after treatment (p<0.05), and the SOD concentration of the observation group was higher than that of the control group (p<0.05).
CONCLUSION
rt-PA intravenous thrombolysis in combination with mild hypothermia therapy has significant efficacy in the treatment of acute cerebral infarction. It can effectively relieve neurological function. Its action mechanism may be realized by relieving oxidative stress response.
目的
探讨重组组织型纤溶酶原激活剂（rt-PA）静脉溶栓联合亚低温治疗急性脑梗死的疗效。
方法
选取我院收治的132例急性脑梗死患者，分为对照组和观察组，每组66例。对照组患者给予常规治疗联合局部亚低温治疗，观察组患者在常规治疗和局部亚低温治疗的基础上给予rt-PA静脉溶栓。记录两组治疗前后的美国国立卫生研究院卒中量表（NIHSS）评分及颅内压（ICP）。评估两组的疗效。采用改良Rankin量表（MRS）评分对患者进行3个月的随访。在溶栓前后采集患者的血样。检测血浆中超氧化物歧化酶（SOD）和丙二醛（MDA）水平。
结果
与治疗前相比，两组患者治疗后1、3、7天的NIHSS评分均降低（p<0.05），但两组患者治疗后不同时间点的NIHSS评分差异无统计学意义（p>0.05）。与治疗前相比，两组患者治疗后1、3、7天的ICP均降低（p<0.05），且观察组在治疗后相同时间点（1、3、7天）ICP的降低幅度均大于对照组（p<0.05）。治疗后观察组的临床疗效高于对照组，差异有统计学意义（p<0.05）。两组患者治疗后不同时间点的MDA浓度均降低（p<0.05），但SOD浓度升高（p<0.05）。治疗后不同时间点观察组的MDA浓度均低于对照组（p<0.05），观察组的SOD浓度高于对照组（p<0.05）。
结论
rt-PA静脉溶栓联合亚低温治疗急性脑梗死疗效显著。可有效缓解神经功能。其作用机制可能是通过减轻氧化应激反应实现。
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