血栓通联合阿替普酶治疗对急性脑梗死患者神经功能的影响及机制研究

目的：探讨血栓通联合阿替普酶治疗对急性脑梗死患者神经功能的影响，并研究其可能的机制。方法：选择2015年3月-2016年12月某院神经内科收治的在发病3 h内的急性脑梗死患者140例，依据抽签法分为观察组（n=70）和常规组（n=70）。常规组采用阿替普酶治疗，观察组采用血栓通联合阿替普酶治疗。比较2组患者治疗前后神经功能指标、血小板参数及CGRP、Hcy和Sicam-1的变化，并观察2组患者治疗效果。结果：2组急性脑梗死患者治疗前S-100β、NGF、NSE和神经功能指标、血小板参数及CGRP、Hcy和sICAM-1水平均无显著性差异（P>0.05）。治疗后，2组患者S-100β、NSE和NIHSS评分，Hcy和sICAM-1水平均有所降低，CGRP、NGF、MVP、PLT和PDW均有所上升（均P<0.05），且观察组患者S-100β、NSE和NIHSS评分，Hcy和sICAM-1水平均低于常规组，CGRP、NGF、MVP、PLT和PDW均高于常规组（均P<0.05）。结论：血栓通联合阿替普酶治疗急性脑梗死患者可显著改善神经功能，其可能是通过改善血小板功能，调节细胞因子的分泌，从而发挥对脑神经细胞保护作用的。

Effects of Xueshuantong combined with alteplase on neurological function in patients with acute cerebral infarction and its mechanism

OBJECTIVE To investigate the effect of Xueshuantong combined with alteplase on neurological function in patients with acute cerebral infarction and to study its potential mechanism. METHODS 140 patients with acute cerebral infarction admitted in our department of Neurology from March 2015 to December 2016 were divided into the observation group (n=70) and the conventional group (n=70) according to the lottery method. The conventional group was treated with alteplase, and the observation group was treated with thromboxane and alteplase.The neurological function, platelet parameters, CGRP, Hcy, and sICAM-1 before and after treatment were compared between the two groups, and the therapeutic effect of the two groups was observed. RESULTS There were no significant differences in neurological function parameters, platelet parameters, CGRP, Hcy, and sICAM-1 levels between the two groups of patients with acute cerebral infarction (P>0.05). After treatment, the S-100β, NSE, and NIHSS scores, Hcy and sICAM-1 levels decreased, and CGRP, NGF, MVP, PLT and PDW increased in both groups (all P<0.05). In observation group, S-100β, NSE and NIHSS scores, Hcy and sICAM-1 levels were lower than those in the conventional group, and CGRP, NGF, MVP, PLT and PDW were higher in the observation group than in the conventional group (all P<0.05). CONCLUSION Thromboxane combined with alteplase in patients with acute cerebral infarction can significantly improve the neurological function, which is mediated by the improvement of platelet function and regulation of the cytokines secretion, thus play a protective effect on brain nerve cells.