阿替普酶联合丁苯酞治疗急性期脑梗死临床观察

目的研究阿替普酶联合丁苯酞治疗急性期脑梗死(ACI)的疗效。方法选择2014-12—2016-11我院收治的早期ACI患者118例,按照随机数字表法分为联合组(n=59)与对照组(n=59)。对照组行基础治疗联合阿替普酶治疗,联合组在对照组基础上给予丁苯酞治疗。观察2组治疗前后血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、脂联素(APN)、单核细胞趋化因子(MCP-1)、可溶性细胞黏附因子-1(sICAM-1)水平,2组治疗后7d、30d日常生活能力(ADL)及NIHSS评分、不良反应及临床疗效。结果治疗后,联合组血清CRP、IL-6、IL-8、MCP-1、sICAM-1均低于对照组,APN高于对照组,差异有统计学意义(P0.05)。治疗后7d、30d联合组NIHSS评分均低于对照组,差异有统计学意义(P0.05)。联合组治疗总有效率(94.92%)高于对照组(81.36%),差异有统计学意义(P0.05)。治疗期间2组均未见明显不良反应。结论阿替普酶联合丁苯酞治疗ACI可有效促进梗死部位血液循环,纠正神经功能缺损,疗效显著,值得临床应用。

Clinical observation of alteplase combined with butyphthalide in the treatment of acute cerebral infarction

Objective To study the effects of alteplase combined with butyphthalide in the treatment of early acute cerebral infarction (ACI)and on neurological function.Methods A total of 118 cases with early ACI admitted to our hospital from Decem-ber 2014 to November 2016 were selected and divided into combination group (n = 59)and control group (n = 59)according to random number table method.On the basis of the combined therapy of basic treatment and alteplase applied to control group,the combination group received butyphthalide.Then the levels of C-reactive protein (CRP),interleukin-6 (IL-6),interleukin-8 (IL-8), adiponectin (APN),monocyte chemotactic protein (MCP-1 )and soluble intercellular adhesion molecule-1 (sICAM-1 )of two groups before and after treatment were observed.Seven days and thirty days after treatment,both the activities of daily living (ADL)and National Institute of Health Stroke Scale (NIHSS)were used to assess the clinical efficacy,and the adverse events were recorded.Results After treatment,the levels of serum CRP,IL-6,IL-8,MCP-1 and sICAM-1 in combination group were lower than those in the control group,while the level of APN was higher than that in control group,and all differences were statis-tically significant (P <0.05).Seven days and thirty days after treatment,the combination group showed more NIHSS scores than the control group (P <0.05).Compared with the control group (94.92％),the combination group (81.36％)presented higher to-tal effective rate (P <0.05).No obvious adverse events were found between two groups during therapy.Conclusion Alteplase in combination with butyphthalide for treating ACI can effectively promote blood circulation of infarction location and can rectify neu-rological function deficits with favorable efficacy,which should be worthy of clinical application.