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静脉溶栓联合动脉溶栓(桥接治疗)可有效提高脑梗死患者血管再通率。

Intravenous Thrombolysis Combined with Arterial Thrombolysis (Bridging Therapy) Effectively Improves Vascular Recanalization Rate in Patients with Cerebral Infarction.

机构信息

Department of Neurology, Beijing Chuiyangliu Hospital, Beijing 100022, China.

出版信息

J Immunol Res. 2022 Jul 26;2022:8295212. doi: 10.1155/2022/8295212. eCollection 2022.

Abstract

OBJECTIVE

To explore the efficacy of intravenous thrombolysis combined with arterial thrombolysis (bridging therapy) in patients with acute cerebral infarction and its effect on serum inflammatory factors.

METHODS

The case data of 138 patients with acute cerebral infarction admitted to our hospital from February 2019 to February 2021 were retrospectively analyzed. According to the treatment plan they received, patients were assigned to two groups, namely, an observation group ( = 71) treated with bridging therapy and a control group ( = 67) treated with intravenous thrombolysis alone. The following indexes were recorded and compared between the two groups: treatment efficacy, National Institutes of Health Stroke Scale (NIHSS) score, activities of daily living, incidence rates of vascular recanalization, intracranial hemorrhage and reembolization after treatment, levels of inflammatory factors before and after treatment, levels of prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (FIB) before and 1 week after treatment, and modified Rankin Scale scores 1, 3, and 6 months after treatment.

RESULTS

Compared with the control group, the therapeutic efficacy, neurological function, activities of daily living, and vascular recanalization were markedly better in the observation group ( > 0.05). In addition, the incidence of intracranial hemorrhage and reembolization was statistically lower in the observation group ( < 0.05). No marked difference was found between the two groups in terms of pretreatment serum inflammatory factors and coagulation function ( > 0.05), while the above indicators improved statistically after treatment in both groups, with comparatively more obvious improvement in the observation group. It was also observed that, compared with the control group, the modified Rankin Scale score in the observation group was significantly better at 3 and 6 months after treatment ( < 0.05).

CONCLUSION

Bridging therapy can improve the vascular recanalization rate among patients suffering from acute cerebral infarction, reduce the incidence of intracranial hemorrhage and reembolization, and improve the prognosis and neurological function of patients, which is worthy of clinical application.

摘要

目的

探讨急性脑梗死患者静脉溶栓联合动脉溶栓(桥接治疗)的疗效及其对血清炎症因子的影响。

方法

回顾性分析 2019 年 2 月至 2021 年 2 月我院收治的 138 例急性脑梗死患者的病例资料,根据其接受的治疗方案分为观察组(n=71)和对照组(n=67),观察组采用桥接治疗,对照组采用单纯静脉溶栓治疗。记录并比较两组患者的治疗效果、美国国立卫生研究院卒中量表(NIHSS)评分、日常生活活动能力、血管再通率、治疗后颅内出血和再栓塞发生率、治疗前后炎症因子水平、治疗前后凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)和纤维蛋白原(FIB)水平、治疗后 1、3、6 个月改良 Rankin 量表(mRS)评分。

结果

观察组治疗总有效率、神经功能、日常生活活动能力及血管再通率均显著优于对照组(P<0.05);观察组颅内出血和再栓塞发生率显著低于对照组(P<0.05)。两组治疗前血清炎症因子和凝血功能比较,差异无统计学意义(P>0.05),治疗后均有明显改善,且观察组改善更为明显(P<0.05)。观察组治疗后 3、6 个月 mRS 评分均显著优于对照组(P<0.05)。

结论

桥接治疗可提高急性脑梗死患者血管再通率,降低颅内出血和再栓塞发生率,改善患者预后和神经功能,具有临床应用价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed4d/9345711/6e5d45fc8f99/JIR2022-8295212.001.jpg

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