Gao Lilin, Zhang Shaojie, Wo Xuewen, Shen Xiangpeng, Tian Qiangyuan, Wang Guoqing
Lilin Gao, Department of Neurology, Binzhou People's Hospital, Shandong 256610, China.
Shaojie Zhang, Department of Neurology, Binzhou People's Hospital, Shandong 256610, China.
Pak J Med Sci. 2022 Mar-Apr;38(3Part-I):498-504. doi: 10.12669/pjms.38.3.4521.
To compare the efficacy and safety of intravenous thrombolysis with alteplase and intravenous thrombolysis with urokinase for patients with acute cerebral infarction.
This prospective study included 140 patients with acute cerebral infarction who were admitted to our hospital between June 2018 and June 2019. They were randomly divided into two groups. The control group (70 cases) was treated with urokinase intravenous thrombolysis, and the observation group (70 cases) was given alteplase intravenous thrombolytic therapy. The treatment efficacy and safety of the two groups were compared.
The total effective rate of the observation group was 95.7%, and that of the control group was 78.6%, i.e., the total effective rate of the observation group was significantly superior to the that of the control group (P < 0.05). After treatment, the observation group had significantly lower National Institutes of Health Stroke Scale (NIHSS) score and significantly higher mini-mental state examination (MMSE) score than the control group; the difference was statistically significant (P<0.05). After treatment, the levels of inflammatory factors of both groups significantly decreased compared to before treatment, and the decrease in the observation group was larger than that in the control group (P<0.05). The levels of serum homocysteine (Hcy) and monocyte chemoattractant protein-1 (MCP-1) in the observation group were significantly lower than those in the control group after treatment, and the differences were statistically significant (P<0.05). The incidence of hemorrhagic adverse reaction in the observation group was lower than that in the control group (P<0.05).
In the treatment of acute cerebral infarction, ccompared with urokinase, alteplase can further relieve cognitive impairment and promote the recovery of nerve function through inhibiting levels of inflammatory factors and levels of serum Hcy and MCP-1.
比较阿替普酶静脉溶栓与尿激酶静脉溶栓治疗急性脑梗死患者的疗效及安全性。
本前瞻性研究纳入了2018年6月至2019年6月期间我院收治的140例急性脑梗死患者。他们被随机分为两组。对照组（70例）采用尿激酶静脉溶栓治疗，观察组（70例）给予阿替普酶静脉溶栓治疗。比较两组的治疗疗效及安全性。
观察组总有效率为95.7%，对照组为78.6%，即观察组总有效率显著高于对照组（P<0.05）。治疗后，观察组美国国立卫生研究院卒中量表（NIHSS）评分显著低于对照组，简易精神状态检查表（MMSE）评分显著高于对照组；差异有统计学意义（P<0.05）。治疗后，两组炎症因子水平均较治疗前显著降低，且观察组降低幅度大于对照组（P<0.05）。治疗后，观察组血清同型半胱氨酸（Hcy）和单核细胞趋化蛋白-1（MCP-1）水平显著低于对照组，差异有统计学意义（P<0.05）。观察组出血不良反应发生率低于对照组（P<0.05）。
在急性脑梗死治疗中，与尿激酶相比，阿替普酶可通过抑制炎症因子水平及血清Hcy和MCP-1水平，进一步缓解认知障碍，促进神经功能恢复。
