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目的探讨rt-PA溶栓治疗对急性缺血性脑卒中患者神经功能及炎性因子的影响。方法选择2014年5月—2016年12月收治的急性缺血性脑卒中患者100例,随机分为观察组与对照组,每组50例。对照组给予常规治疗,观察组在对照组治疗基础上加rt-PA溶栓治疗,先以总量的10%于1~2 min静脉推注;剩余的90%以1:5的比例加入生理盐水持续静脉滴注1 h。分别于治疗前及治疗后24 h、7 d采用美国国立卫生院神经功能缺损评分(National institute of health stroke scale,NIHSS)评价患者的神经功能缺损程度,日常生活活动能力(activities of daily living,ADL)进行评分,检测血清白细胞介素6(interleukin-6,IL-6)。计量资料比较采用t检验或重复测量方差分析,P<0.05为差异有统计学意义。结果治疗后24 h、7 d两组NIHSS均较治疗前降低(均P<0.05);治疗后24 h、7 d观察组NIHSS[(16.19±4.32)、(10.80±3.35)分]低于对照组[(18.35±3.06)、(16.94±4.17)分],两组比较差异有统计学意义(均P<0.05)。治疗后7 d两组ADL评分均较治疗前升高(均P<0.05);治疗后7 d观察组ADL评分[(80.35±12.09)分]高于对照组[(61.53±13.05)分],两组比较差异有统计学意义(P<0.05)。治疗后7 d两组血清IL-6水平均较治疗前降低(均P<0.05);治疗后7 d观察组血清IL-6水平[(77.06±15.43)ng/ml]低于对照组[(90.84±12.67)ng/ml],两组比较差异有统计学意义(P<0.05)。结论 rt-PA溶栓治疗可促进急性缺血性脑卒中患者神经功能恢复,降低炎性因子水平。
Objective To investigate the effect of rt-PA thrombolytic therapy on neurological function and inflammatory factors in patients with acute ischemic stroke. Methods One hundred patients with acute ischemic stroke who were admitted from May 2014 to December 2016 were randomly divided into observation group and control group with 50 cases in each group. The control group was given routine treatment. The observation group was treated with rt-PA thrombolytic therapy on the basis of the control group. The patients were intravenously injected with 10% of the total volume at 1-2 minutes. The remaining 90% were added into the physiology at a ratio of 1: 5 Saline continuous intravenous infusion 1 h. The degree of neurological deficit, activity of daily living (ADL), and the severity of neurological deficits were evaluated before treatment and 24 h and 7 d after treatment by using the National Institute of Health Stroke Scale (NIHSS) ) Were scored for the detection of serum interleukin-6 (IL-6). Measurement data were compared using t test or repeated measures analysis of variance, P <0.05 for the difference was statistically significant. Results The NIHSS of the two groups after 24 h and 7 d treatment were lower than those before treatment (both P <0.05). NIHSS [(16.19 ± 4.32) and (10.80 ± 3.35) min after treatment in the observation group 24 h and 7 d after treatment were lower than those in the control Group [(18.35 ± 3.06), (16.94 ± 4.17) points], the difference between the two groups was statistically significant (all P <0.05). The ADL score of the two groups was significantly higher than that before treatment on the 7th day after treatment (both P <0.05). ADL score [(80.35 ± 12.09) points] in the observation group on the 7th day after treatment was significantly higher than that of the control group [(61.53 ± 13.05) The difference between the two groups was statistically significant (P <0.05). Serum IL-6 levels in both groups were lower than those before treatment on the 7th day after treatment (all P <0.05); serum IL-6 level in the observation group was significantly lower than that of the control group [(77.06 ± 15.43) ng / ml on the 7th day after treatment 90.84 ± 12.67) ng / ml], the difference between the two groups was statistically significant (P <0.05). Conclusion rt-PA thrombolytic therapy can promote the recovery of neurological function and reduce the level of inflammatory cytokines in patients with acute ischemic stroke.