【摘要】 目的探讨阿替普酶对急性脑梗死神经功能损伤及血清神经元特异性烯醇化酶(NSE)、高敏C反应蛋白(hs-CRP)的影响。方法选取华中科技大学同济医学院附属武汉市中心医院自2013年4月至2018年5月收治的80例急性脑梗死患者为研究对象,将患者随机分为A组(n=38)与B组(n=42)。A组采用替罗非班治疗;B组在A组的基础上,给予阿替普酶进行溶栓治疗。比较两组患者的临床疗效及不良反应发生率。记录并比较两组患者的NSE、S100β蛋白、胶质纤维酸性蛋白(GFAP)、hs-CRP、白细胞介素-1β(IL-1β)及肿瘤坏死因子-α(TNF-α)水平。结果 B组患者治疗总有效率为90.5%(38/42),明显高于A组的73.7%(28/38),两组间比较,差异有统计学意义(P<0.05)。与治疗前比较,治疗后两组患者的NSE、S100β蛋白、GFAP及hs-CRP、IL-1β、TNF-α均明显降低,且B组明显低于A组,两组间比较,差异有统计学意义(P<0.05)。A、B两组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。结论阿替普酶治疗急性脑梗死患者,可以明显降低炎性反应,改善患者的神经功能,提高临床疗效。更多还原

【Abstract】 Objective To investigate the effect of alteplase on nerve function injury in acute cerebral infarction(ACI),serum neuron-specific enolase(NSE)and high sensitivity C-reactive protein(hs-CRP).Methods A retrospective study was performed on 80 cases of patients with ACI who were admitted from April 2013 to May 2018.Patients were randomly divided into the Group A(n=38)and Group B(n=42).Patients of Group A were treated with tirofiban,the others of Group B were added alteplase on the basis of treatment in Group A.The clinical efficacy and incidence of adverse reactions were compared between the two groups.NSE,S100β,glial fibrillar acidic protein(GFAP),hs-CRP,interleukin-1β(IL-1β),and tumor necrosis factor-α(TNF-α)levels were recorded and compared between the two groups.Results The total effective rate of Group B was 90.5%(38/42),significantly higher than 73.7%(28/38)of Group A,with statistically significant difference between the two groups(P<0.05).The NSE,S100β,GFAP,hs-CRP,IL-1βand TNF-α of the two groups were significantly lower than those of the two groups before and after treatment(P<0.05).There was no significant difference in the incidence of adverse reactions between Group A and Group B(P>0.05).Conclusion Alteplase can significantly reduce the inflammatory status of patients with acute cerebral infarction,improve the neurological impairment of patients and the clinical efficacy.更多还原