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目的探讨阿替普酶静脉溶栓治疗轻中度急性缺血性脑卒中的疗效及对患者血清炎性因子和同型半胱氨酸(Hcy)水平的影响。方法将240例轻中度急性缺血性脑卒中患者随机分为观察组和对照组各120例。观察组给予阿替普酶溶栓治疗,对照组给予常规治疗。检测2组治疗前后血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)和同型半胱氨酸(Hcy)水平,比较2组总有效率和不良反应。结果治疗前2组患者血清IL-6、TNF-α、CRP及Hcy水平比较差异无统计学意义(P>0.05),治疗后2组患者上述指标均显著降低(P<0.05),且观察组低于对照组(P<0.05);观察组总有效率为95.83%显著高于对照组的80.83%,差异有统计学意义(P<0.05);2组不良反应发生率比较差异无统计学意义(P>0.05)。结论阿替普酶静脉溶栓治疗轻中度急性缺血性脑卒中可显著降低患者血清炎性因子水平,提高了治疗效果,改善患者的预后,值得临床推广应用。
Objective To investigate the effect of intravenous thrombolytic therapy of alteplase on mild to moderate acute ischemic stroke and its effect on the levels of serum inflammatory cytokines and homocysteine (Hcy). Methods A total of 240 mild to moderate acute ischemic stroke patients were randomly divided into observation group and control group with 120 cases each. The observation group received alteplase thrombolytic therapy and the control group received conventional therapy. The levels of serum IL-6, TNF-α, CRP and Hcy in both groups were measured before and after treatment. Efficiency and adverse reactions. Results There was no significant difference in serum IL-6, TNF-α, CRP and Hcy levels between the two groups before treatment (P> 0.05). After treatment, the above indexes in both groups were significantly decreased (P <0.05) (P <0.05). The total effective rate in the observation group was 95.83%, which was significantly higher than that in the control group (80.83%, P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusion Intravenous thrombolysis with alteplase in mild to moderate acute ischemic stroke can significantly reduce the level of serum inflammatory cytokines, improve the therapeutic effect and improve the prognosis of patients, which is worthy of clinical application.