强化药物方案对溶栓时间窗外急性脑梗死病人临床疗效、炎症相关因子及Hcy水平的影响
摘要
目的探讨强化药物方案对溶栓时间窗外急性脑梗死病人临床疗效、炎症相关因子及同型半胱氨酸(Hcy)水平的影响。方法选取我院2015年11月—2017年11月收治的溶栓时间窗外急性脑梗死病人108例,随机分为对照组(54例)和联合组(54例)。两组常规干预基础相同,对照组给予阿司匹林+氯吡格雷;联合组给予阿司匹林+氯吡格雷+阿加曲班抗凝方案治疗。比较两组临床疗效、美国国立卫生研究院卒中量表(NIHSS)评分、改良RS评分、Barthel指数评分、血流动力学指标、炎症相关因子及Hcy水平。结果治疗后联合组临床疗效显著优于对照组(P<0.05);联合组NIHSS、改良RS评分及Barthel指数均显著优于对照组及本组治疗前(P<0.05);联合组治疗后脑部血流动力学指标和血液流变学指标均显著优于对照组及本组治疗前(P<0.05);联合组治疗后炎症相关因子和Hcy水平均显著低于对照组及本组治疗前(P<0.05)。结论强化药物方案用于溶栓时间窗外急性脑梗死病人能够保护受损神经功能,降低总体残疾程度,增加脑部血流灌注量,并有助于下调炎症相关因子和Hcy水平。
引文
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[12] ZAHARAN N L,WILLIAMS D,BENNETT K.Statins and risk of treated incident diabetes in a primary care population[J].Br J Clin Pharmacol,2013,75(4):1118-1124
[13] STONE N J,ROBINSON J G,LICHTENSTEIN A H,et al.2013 ACC/AHA Guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular Risk in Adults:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines[J].J Am Coll Cardiol,2014,63 (25 Pt B):2889-2934.
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[15] ADEOYE O,KNIGHT W A,KHOURY J,et al.A matched comparison of eptifibatide plus rt-PA versus rt-PA alone in acute ischemic stroke[J].J Stroke Cerebrovasc Dis,2014,23(4):e313-e315.
[16] SCHELLINGS D A,ADIYAMAN A,GIANNITSIS E,et al.Early discharge after primary percutaneous coronary intervention:the added value of N-terminal probrain natriuretic peptide to the zwolle risk score[J].J Am Heart Assoc,2014,3(6):11-17.
[2] FU H J,ZHAO L B,XUE J J,et al.Elevated serum homocysteine (Hcy) levels may contribute to the pathogenesis of cerebral infarction[J].J Mol Neurosci,2015,56(3):553-561.
[3] LIN Z J,QIU H Y,TONG X,et al.Evaluation of efficacy and safety of reteplase and alteplase in the treatment of hyperacute cerebral infarction[J].Biosci Rep,2017,38(1):BSR20170730.
[4] 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.
[5] 中国脑梗死急性期康复专家共识组.中国脑梗死急性期康复专家共识[J].中华物理医学与康复杂志,2016,38(1):1-6.
[6] GAJIN P,RADAK D J,TANASKOVIC S,et al.Urgent carotid endarterectomy in patients with acute neurological ischemic events within six hours after symptoms onset[J].Vascular,2014,22(3):167-173.
[7] SHUCK J,ENDARA M,DAVISON S P.Management of intraoperative free flap arterial thrombosis with of argatroban in the heparin-allergic patient[J].Plant Rcconstr Surg,2014,134(3):672e.
[8] OGURO H,MITAKI S,TAKAYOSHI H,et al.Retrospective analysis of argatroban in 353 patients with acute noncardioembolic stroke[J].J Stroke Cerebrovasc Dis,2018,18(4):30169.
[9] KAJERMO U,ULVENSTAM A,MODICA A,et al.lncidence,trends,and predictors of ischemic stroke 30 days after an acute myocardial infarction[J].Stroke,2014,45(2):1324-1330.
[10] AKDEMIR H U,YARDAN T,KATI C,et al.The role of S100B protein neuron-pecific enolase,and filial fibrillary acidic;protein in the evaluation of hypoxic;brain injury in acute carbon monoxide poisoning[J].Hum Exp Toxico1,2014,33(11):1113-1120.
[11] ZHANG C,ZHANG Z,ZHAO Q,et al.(S) -ZJM-289 preconditioning induces a late phase protection against nervous injury induced by transient cerebral ischemia and oxyger glucose deprivation[J].Neurotox Res,2014,26(3):16-31.
[12] ZAHARAN N L,WILLIAMS D,BENNETT K.Statins and risk of treated incident diabetes in a primary care population[J].Br J Clin Pharmacol,2013,75(4):1118-1124
[13] STONE N J,ROBINSON J G,LICHTENSTEIN A H,et al.2013 ACC/AHA Guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular Risk in Adults:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines[J].J Am Coll Cardiol,2014,63 (25 Pt B):2889-2934.
[14] ESTEVE-PASTOR M A,HERNáNDEZ-ROMERO D,VALDéS M,et al.New approaches to the role of thrombin in acute coronary syndromes:quo vadis bivalirudin,a direct thrombin Inhibitor?[J].Molecules,2016,21(3):284.
[15] ADEOYE O,KNIGHT W A,KHOURY J,et al.A matched comparison of eptifibatide plus rt-PA versus rt-PA alone in acute ischemic stroke[J].J Stroke Cerebrovasc Dis,2014,23(4):e313-e315.
[16] SCHELLINGS D A,ADIYAMAN A,GIANNITSIS E,et al.Early discharge after primary percutaneous coronary intervention:the added value of N-terminal probrain natriuretic peptide to the zwolle risk score[J].J Am Heart Assoc,2014,3(6):11-17.