尿激酶静脉溶栓联合尤瑞克林对脑梗死患者血清基质金属蛋白酶-9和血管内皮生长因子水平的影响
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摘要
目的:观察尿激酶静脉溶栓联合尤瑞克林对脑梗死患者血清基质金属蛋白酶-9(MMP-9)和血管内皮生长因子(VEGF)水平的影响。方法:选择2017-01—2018-12恩施亚菲亚妇产医院急诊科收治的脑梗死患者100例作为研究对象,采用随机数字表法将患者分为研究组和对照组,每组各50例。对照组采用尿激酶静脉溶栓治疗,研究组在对照组基础上联合尤瑞克林治疗。采用双抗夹心酶联免疫吸附法(DAS-ELISA)测定治疗前及治疗14天后患者血清MMP-9、VEGF水平。结果:研究组患者治疗总有效率明显高于对照组(P<0.05)。治疗前,两组患者血清MMP-9,VEGF水平比较差异无统计学意义(P>0.05),治疗后,两组患者血清MMP-9水平明显低于治疗前,血清VEGF水平明显高于治疗前(P<0.05),其中研究组上述血清指标的改善幅度更明显(P<0.05)。治疗后,两组美国国立卫生研究院卒中量表(NIHSS)和日常生活活动能力(ADL)评分明显降低或升高,且研究组降低或增高幅度更明显(P<0.05)。两组药物不良反应比较差异无统计学意义(P>0.05)。结论:尿激酶静脉溶栓联合尤瑞克林治疗脑梗死患者的疗效满意,值得临床推广应用。
Objective: To study the effect of urokinase intravenous thrombolysis combined urinarykallid on serum MMP-9 and VEGF levels in patients with cerebral infarction.Method: A total of 100 cases of cerebral infarction patients from January 2017 to December 2018 were selected as the study subjects. The patients were divided into study group and control group by using the random number table method, with 50 cases in each group. The control group were treated with urokinase intravenous thrombolysis combined urinarykallid, while the study group were treated with urokinase intravenous thrombolysis combined urinarykallid. The serum levels of MMP-9 and VEGF were detected by double anti-sandwich enzyme-linked immunosorbent assay(DAS-ELISA). Results: The total effective rate in the study group was significantly higher than that in the control group(P<0.05).Before treatment, there was no significant difference in serum MMP-9 and VEGF levels while compared between the two groups(P>0.05). After treatment, serum MMP-9 levels of the two groups were significantly lower than pre-therapy, and serum VEGF levels were significantly higher than pre-therapy(P<0.05).After treatment, ADL scores of the two groups were significantly higher than those pre-therapy, and the increase was more significant in the study group(P<0.05).There was no significant difference in adverse drug reactions while compared between the two groups(P>0.05).Conclusion: The effect of urokinase intravenous thrombolysis combined urinarykallid in the treatment of patients with cerebral infarction is satisfying and worthy of clinical promotion and application.
Objective: To study the effect of urokinase intravenous thrombolysis combined urinarykallid on serum MMP-9 and VEGF levels in patients with cerebral infarction.Method: A total of 100 cases of cerebral infarction patients from January 2017 to December 2018 were selected as the study subjects. The patients were divided into study group and control group by using the random number table method, with 50 cases in each group. The control group were treated with urokinase intravenous thrombolysis combined urinarykallid, while the study group were treated with urokinase intravenous thrombolysis combined urinarykallid. The serum levels of MMP-9 and VEGF were detected by double anti-sandwich enzyme-linked immunosorbent assay(DAS-ELISA). Results: The total effective rate in the study group was significantly higher than that in the control group(P<0.05).Before treatment, there was no significant difference in serum MMP-9 and VEGF levels while compared between the two groups(P>0.05). After treatment, serum MMP-9 levels of the two groups were significantly lower than pre-therapy, and serum VEGF levels were significantly higher than pre-therapy(P<0.05).After treatment, ADL scores of the two groups were significantly higher than those pre-therapy, and the increase was more significant in the study group(P<0.05).There was no significant difference in adverse drug reactions while compared between the two groups(P>0.05).Conclusion: The effect of urokinase intravenous thrombolysis combined urinarykallid in the treatment of patients with cerebral infarction is satisfying and worthy of clinical promotion and application.
引文
1 Wang J,Zhang Y,Xu F.Function and mechanism of microRNA-210 in acute cerebral infarction.[J].Exp Ther Med,2018,15(2):1 263-1 268.
2 李艳.尿激酶静脉溶栓应用于超早期脑梗塞的临床效果及安全性[J].临床医学研究与实践,2018,3(10):27-28.
3 姜晨辉,赵国庆,闻世祺.注射用尤瑞克林治疗心源性脑栓塞的效果研究[J].中国医药指南,2018,16(2):107-108.
4 Zhu Y,Zhang X,Lou X,et al.Vascular endothelial growth factor (VEGF) antibody significantly increases the risk of hand–foot skin reaction to multikinase inhibitors (MKIs):A systematic literature review and meta-analysis[J].Clin Exp Pharmacol Physiol,2018,45(7):659-667.
5 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
6 蔚春生,耿超群,吴干斌,等.血清中炎性因子在急性脑梗死患者中的临床价值分析[J].中国实用神经疾病杂志,2018,21(13):1 475-1 479.
7 Victor C,Mahesh K,Kosior JC,et al.National institutes of health stroke scale score is an unreliable predictor of perfusion deficits in acute stroke[J].Int J Stroke,2015,10(4):582-588.
8 Cho MJ,Jung EK,Jung YS,et al.Relationship between the activities of daily living,oral health-related quality of life and dementia[J].Geriatr Gerontol Int,2018,18(6):943-949.
9 张东林,孟庆阳,李爱华,等.三七粉联合尿激酶溶栓治疗脑梗死患者的疗效观察[J].癫痫与神经电生理学杂志,2018,27(2):97-100.
10 潘军利,刘中华.尤瑞克林治疗中青年进展性脑梗死的疗效分析[J].实用医药杂志,2018,35(2):132-133.
11 周晓梅,韩光.老年急性脑梗死病人使用尤瑞克林治疗后血液流变学变化[J].实用老年医学,2018,18(3):270-272.
12 李昌盛,闵喆,杨贤义,等.尤瑞克林对心脏骤停后综合征兔脑保护作用的研究[J].神经损伤与功能重建,2018,13(5):221-224.
13 谢鹏,张王山,黄国金.尤瑞克林后处理对心肌缺血再灌注损伤的保护作用[J].现代中西医结合杂志,2013,22(28):3 093-3 094.
14 邹斌,张兆辉.尤瑞克林联合曲克卢丁对急性脑梗塞患者凝血功能及神经功能的影响[J].海南医学院学报,2015,21(6):841-843.
15 魏芳,仝秀清,马琳,等.脑苷肌肽对老年脑梗死患者hsCRP、VEGF、TGF-β1水平及疗效的影响[J].中国临床研究,2018,31(1):9-12.
16 赵凤华,袁方.阿替普酶联合尤瑞克林治疗急性脑梗死的效果及对神经功能与脑血管储备功能的影响[J].中国实用医刊,2018,45(8):116-118.
2 李艳.尿激酶静脉溶栓应用于超早期脑梗塞的临床效果及安全性[J].临床医学研究与实践,2018,3(10):27-28.
3 姜晨辉,赵国庆,闻世祺.注射用尤瑞克林治疗心源性脑栓塞的效果研究[J].中国医药指南,2018,16(2):107-108.
4 Zhu Y,Zhang X,Lou X,et al.Vascular endothelial growth factor (VEGF) antibody significantly increases the risk of hand–foot skin reaction to multikinase inhibitors (MKIs):A systematic literature review and meta-analysis[J].Clin Exp Pharmacol Physiol,2018,45(7):659-667.
5 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
6 蔚春生,耿超群,吴干斌,等.血清中炎性因子在急性脑梗死患者中的临床价值分析[J].中国实用神经疾病杂志,2018,21(13):1 475-1 479.
7 Victor C,Mahesh K,Kosior JC,et al.National institutes of health stroke scale score is an unreliable predictor of perfusion deficits in acute stroke[J].Int J Stroke,2015,10(4):582-588.
8 Cho MJ,Jung EK,Jung YS,et al.Relationship between the activities of daily living,oral health-related quality of life and dementia[J].Geriatr Gerontol Int,2018,18(6):943-949.
9 张东林,孟庆阳,李爱华,等.三七粉联合尿激酶溶栓治疗脑梗死患者的疗效观察[J].癫痫与神经电生理学杂志,2018,27(2):97-100.
10 潘军利,刘中华.尤瑞克林治疗中青年进展性脑梗死的疗效分析[J].实用医药杂志,2018,35(2):132-133.
11 周晓梅,韩光.老年急性脑梗死病人使用尤瑞克林治疗后血液流变学变化[J].实用老年医学,2018,18(3):270-272.
12 李昌盛,闵喆,杨贤义,等.尤瑞克林对心脏骤停后综合征兔脑保护作用的研究[J].神经损伤与功能重建,2018,13(5):221-224.
13 谢鹏,张王山,黄国金.尤瑞克林后处理对心肌缺血再灌注损伤的保护作用[J].现代中西医结合杂志,2013,22(28):3 093-3 094.
14 邹斌,张兆辉.尤瑞克林联合曲克卢丁对急性脑梗塞患者凝血功能及神经功能的影响[J].海南医学院学报,2015,21(6):841-843.
15 魏芳,仝秀清,马琳,等.脑苷肌肽对老年脑梗死患者hsCRP、VEGF、TGF-β1水平及疗效的影响[J].中国临床研究,2018,31(1):9-12.
16 赵凤华,袁方.阿替普酶联合尤瑞克林治疗急性脑梗死的效果及对神经功能与脑血管储备功能的影响[J].中国实用医刊,2018,45(8):116-118.