尤瑞克林联合静脉溶栓剂对急性脑梗死患者治疗效果及血清学指标的影响

目的探讨尤瑞克林联合重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓对前循环急性脑梗死患者的临床疗效及血管内皮钙黏蛋白(VE-cadherin)与单核细胞趋化因子1(MCP-1)表达水平的影响。方法选择2016年2月~2018年2月在我院就诊的前循环急性脑梗死患者114例,按照随机数字表随机纳入对照组(rt-PA静脉溶栓)和观察组(尤瑞克林+rt-PA静脉溶栓),每组57例,观察2组治疗前及治疗后美国国立卫生研究院卒中量表(NIHSS)评分、改良的Rankin量表(mRS)评分、血清VE-cadherin及MCP-1表达水平差异,记录2组不良事件的发生率。结果2组治疗后24 h、7 d NIHSS评分较治疗前均明显下降(P<0.05);治疗后7 d观察组有效率高于对照组(61.4%vs 42.1%,P=0.040)。与治疗前比较,治疗1个月后2组MCP-1、VE-cadherin均显著降低(P<0.05),且观察组显著低于对照组,差异有统计学意义(P<0.05)。治疗3个月后mRS评分比较,观察组0~2分比例明显高于对照组(43.9%vs 22.8%,P=0.017),观察组5~6分比例明显低于对照组(10.5%vs 24.6%,P=0.049),观察组3~4分比例与对照组接近,差异无统计学意义(45.6%vs 52.6%,P>0.05)。观察组不良事件发生率明显低于对照组(3.5%vs 14.0%,P<0.05)。结论尤瑞克林联合rt-PA静脉溶栓治疗急性前循环脑梗死,可减轻患者神经功能症状及病情严重程度,下调VE-cadherin及MCP-1表达水平。

Effect of urinary kallikrein combined with intravenous thrombolytics rt-PA on outcome and serum parameters in acute cerebral infarction patients

Objective To study the clinical efficacy of urinary kallikrein combined with intravenous thrombolytics rt-PA in patients with anterior circulation acute cerebral infarction(ACI)and its effect on expression of vascular endothelial cell cadherin(VE-cadherin)and monocyte chemotactic protein 1(MCP-1).Methods One hundred and fourteen anterior circulation ACI patients admitted to our hospital from February 2016 to February 2018 were randomly divided into control group(n=57)and observation group(n=57).The patients in control group were treated with intravenous thrombolytics rt-PA while those in observation group were treated with urinary kallikrein+intravenous thrombolytics rt-PA.The NIHSS score,mRS score and incidence of adverse events were recorded and the expressions of VE-cadherin and MCP-1 were detected in two groups before and after treatment.Results The NIHSS score was significantly lower in two groups after 24 h and 7 days of treatment(P<0.05).The effective therapeutic rate was significantly higher in observation group than in control group after 7 days of treatment(61.4%vs 42.1%,P=0.040).The expression levels of VE-cadherin and MCP-1 were significantly lower in two groups after 1 month of treatment than before treatment and in observation group than in control group(P<0.05).The rate of 0-2 mRS score was significantly higher while that of 5-6 mRS score was significantly lower in observation group than in control group after 3 months of treatment(43.9%vs 22.8%,P=0.017;10.5%vs 24.6%,P=0.049).No significant difference was detected in rat of 3-4 mRS score between the two groups(45.6%vs 52.6%,P>0.05).The incidence of adverse events was significantly lower in observation group than in control group(3.5%vs 14.0%,P<0.05).Conclusion Urinary kallikrein combined with intravenous thrombolytics rt-PA can improve the neurological symptoms and condition of anterior circulation ACI patients and downregulate the expression levels of VE-cadherin and MCP-1.