尿激酶静脉溶栓与阿司匹林、氯吡格雷联合治疗老年早期脑梗死的疗效及安全性分析
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摘要
目的探讨尿激酶静脉溶栓与阿司匹林、氯吡格雷联合治疗老年早期脑梗死的疗效及安全性。方法选取本院2015年1月至2018年2月收治的老年早期脑梗死患者112例,按随机数字表法分为2组,各56例。对照组采用尿激酶静脉溶栓及口服阿司匹林治疗,观察组在此基础上联合氯吡格雷抗血小板治疗。对比两组临床疗效、安全性及治疗前后血流动力学指标。结果观察组临床疗效高于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率与对照组相比无明显差异(P>0.05);观察组治疗后红细胞比容、全血比黏度、血浆比黏度、纤维蛋白原均低于对照组,差异有统计学意义(P<0.05)。结论尿激酶静脉溶栓与阿司匹林、氯吡格雷联合治疗老年早期脑梗死可有效提高临床疗效,改善血流动力学指标,且具备一定安全性,有临床应用价值。
Objective To investigate the efficacy and safety of intravenous thrombolysis of urokinase combined with aspirin and clopidogrel in the treatment of early cerebral infarction in the elderly. Method 112 patients with early-stage cerebral infarction treated in our hospital from January 2015 to February 2018 were randomly divided into two groups according to the random number table method, 56 cases in each group. In the control group, intravenous thrombolysis with urokinase and oral aspirin were used. The observation group was combined with clopidogrel antiplatelet therapy. The clinical efficacy, safety and hemodynamic parameters before and after treatment were compared between the two groups. Results The clinical efficacy of the observation group was higher than that of the control group, the difference was statistically significant(P<0.05). The incidence of adverse reactions in the observation group had no significant differences compared with the control group(P>0.05); the hematocrit, blood specific viscosity, plasma specific viscosity and fibrinogen of the observation group after treatment were all lower than those in the control group, and the differences were statistically significant(P<0.05). Conclusion The combined treatment of intravenous thrombolysis of urokinase with aspirin and clopidogrel in the trerapy of early cerebral infarction in the elderly can effectively improve the clinical effect and hemodynamic index, and has a certain safety. It is worth applying in clinic.
Objective To investigate the efficacy and safety of intravenous thrombolysis of urokinase combined with aspirin and clopidogrel in the treatment of early cerebral infarction in the elderly. Method 112 patients with early-stage cerebral infarction treated in our hospital from January 2015 to February 2018 were randomly divided into two groups according to the random number table method, 56 cases in each group. In the control group, intravenous thrombolysis with urokinase and oral aspirin were used. The observation group was combined with clopidogrel antiplatelet therapy. The clinical efficacy, safety and hemodynamic parameters before and after treatment were compared between the two groups. Results The clinical efficacy of the observation group was higher than that of the control group, the difference was statistically significant(P<0.05). The incidence of adverse reactions in the observation group had no significant differences compared with the control group(P>0.05); the hematocrit, blood specific viscosity, plasma specific viscosity and fibrinogen of the observation group after treatment were all lower than those in the control group, and the differences were statistically significant(P<0.05). Conclusion The combined treatment of intravenous thrombolysis of urokinase with aspirin and clopidogrel in the trerapy of early cerebral infarction in the elderly can effectively improve the clinical effect and hemodynamic index, and has a certain safety. It is worth applying in clinic.
引文
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[12]Li Y,Zhang X,Cui L,et al.Salvianolic acids enhance cerebral angiogenesis and neurological recovery by activating JAK2/STAT3signaling pathway after ischemic stroke in mice[J].J Neurochem,2017,143(1):87-99.
[13]Zhang Y,Qiu B,Wang J,et al.Effects of BDNF-transfected BMSCs on neural functional recovery and synaptophysin expression in rats with cerebral infarction[J].Mol Neurobiol,2017,54(5):3813-3824.
[14]Su Y C,Lim S N,Yang F Y,et al.Evaluation of cerebral blood flow in acute ischemic stroke patients with atrial fibrillation:Asonographic study[J].J Formos Med Assoc,2017,116(4):287-294.
[15]Mao L,Li P,Zhu W,et al.Regulatory T cells ameliorate tissue plasminogen activator-induced brain haemorrhage after stroke[J].Brain,2017,140(7):1914-1931.
[16]Bhogal P,Bücke P,Ganslandt O,et al.Mechanical thrombectomy in patients with M1 occlusion and NIHSS score≤5:a single-centre experience[J].Stroke Vasc Neurol,2016,1(4):165-171.
[17]Otani Y,okunaga K,Kawauchi S,et al.Cerebral infarction arising from takotsubo cardiomyopathy:case report and literature review[J].NMC Case Rep J,2016,3(4):119-123.
[2]Llovera G,Benakis C,Enzmann G,et al.The choroid plexus is a key cerebral invasion route for T cells after stroke[J].Acta Neuropathol,2017,134(6):851-868.
[3]Korematsu S,Yamada H,Miyahara H,et al.Increased levels of antiphosphatidylcholine and anti-phosphatidylethanolamine antibodies in pediatric patients with cerebral infarction[J].Brain Dev,2017,39(6):542-546.
[4]Chen J,Cui C,Yang X,et al.MiR-126 affects brain-heart interaction after cerebral ischemic stroke[J].Transl Stroke Res,2017,8(4):374-385.
[5]Tornero D,Tsupykov O,Granmo M,et al.Synaptic inputs from strokeinjured brain to grafted human stem cell-derived neurons activated by sensory stimuli[J].Brain,2017,140(3):692-706.
[6]Dengler N F,Diesing D,Sarrafzadeh A,et al.The barrow neurological institute scale revisited:predictive capabilities for cerebral infarction and clinical outcome in patients with aneurysmal subarachnoid hemorrhage[J].Neurosurgery,2017,81(2):341-349.
[7]周汇文.他汀类药物对急性脑梗死病人颈动脉粥样硬化斑块及炎症反应的影响[J].中西医结合心脑血管病杂志,2018,16(4):481-484.
[8]Zhang R C,Mu Y F,Dong J,et al.Complex effects of apoplexy secondary to pituitary adenoma[J].Rev Neurosci,2017,28(1):59-64.
[9]Akutagawa N,Sadashima S,Nakagaki H,et al.Intracerebral hemorrhage after intravenous recombinant tissue plasminogen activator(rt-PA)therapy for acute cerebral infarction in a patient with ANCA-associated vasculitis[J].Rinsho Shinkeigaku,2017,57(8):454-456.
[10]Sakalauskait?-Juodeikien?E,Jatu?is D.Descriptions of apoplexy by joseph frank in the beginning of the nineteenth century in vilnius[J].Eur Neurol,2017,78(1-2):8-14.
[11]Thorén M,Azevedo E,Dawson J,et al.Predictors for cerebral edema in acute ischemic stroke treated with intravenous thrombolysis[J].Stroke,2017,48(9):2464-2471.
[12]Li Y,Zhang X,Cui L,et al.Salvianolic acids enhance cerebral angiogenesis and neurological recovery by activating JAK2/STAT3signaling pathway after ischemic stroke in mice[J].J Neurochem,2017,143(1):87-99.
[13]Zhang Y,Qiu B,Wang J,et al.Effects of BDNF-transfected BMSCs on neural functional recovery and synaptophysin expression in rats with cerebral infarction[J].Mol Neurobiol,2017,54(5):3813-3824.
[14]Su Y C,Lim S N,Yang F Y,et al.Evaluation of cerebral blood flow in acute ischemic stroke patients with atrial fibrillation:Asonographic study[J].J Formos Med Assoc,2017,116(4):287-294.
[15]Mao L,Li P,Zhu W,et al.Regulatory T cells ameliorate tissue plasminogen activator-induced brain haemorrhage after stroke[J].Brain,2017,140(7):1914-1931.
[16]Bhogal P,Bücke P,Ganslandt O,et al.Mechanical thrombectomy in patients with M1 occlusion and NIHSS score≤5:a single-centre experience[J].Stroke Vasc Neurol,2016,1(4):165-171.
[17]Otani Y,okunaga K,Kawauchi S,et al.Cerebral infarction arising from takotsubo cardiomyopathy:case report and literature review[J].NMC Case Rep J,2016,3(4):119-123.