本文已被：浏览 775次 下载 535次
Received:August 22, 2019 Published Online:April 20, 2020
Received:August 22, 2019 Published Online:April 20, 2020
中文摘要: 目的 探讨Solitaire AB支架取栓术联合替罗非班和丁苯酞注射液治疗急性脑梗死（ACI）患者的疗效,并分析其对患者神经功能和炎性因子的影响。
方法 选取2017年1月至2018年12月收治的ACI患者120例,根据随机数字表法分为联合组和对照组,各60例。对照组采用Solitaire AB支架取栓术进行治疗,联合组采用Solitaire AB支架取栓术联合替罗非班和丁苯酞注射液进行治疗。比较两组患者的血管再通、术后并发症及死亡、神经功能恢复情况,比较两组患者血清神经元特异性烯醇化酶(NSE)、钙结合蛋白S100-β、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平。
结果 按脑梗死溶栓治疗(TICI)评分分级评价两组患者的血管再通情况,秩和检验结果示差异有统计学意义(Hc=4.655,P=0.031);按血管再通率评价,χ2检验结果示联合组的血管再通率稍高于对照组,但差异无统计学意义(90.00% vs 83.33%,χ2=1.154,P=0.283)。两组患者术后症状性出血、肺部感染的发生率及死亡率比较差异无统计学意义(P均>0.05)。两组患者术后14 d的美国国立卫生研究院卒中量表(NIHSS)评分、术后3个月改良的Rankin评分(mRS)评分较术前降低(P均<0.05),且联合组低于对照组(P<0.05,P<0.01)。术后14 d,两组患者的血清NSE、S100-β、TNF-α、IL-6水平较术前降低(P均<0.05),且联合组显著低于对照组(P均<0.01)。
结论 Solitaire AB支架取栓术联合替罗非班和丁苯酞注射液治疗ACI安全有效,并可有效改善患者的神经功能和体内的炎症反应。
Abstract:Objective To investigate the curative effect of Solitaire AB stent thrombectomy combined with tirofiban and butylphthalide injection in the treatment of patients with acute cerebral infarction(ACI),and to analyze its effect on nerve function and inflammatory factors.
Methods A total of 120 patients with ACI who received treatment from January 2017 to December 2018 were selected and divided into combined group and control group randomly (n=60,each).The control group was treated with Solitaire AB stent thrombectomy,while the combined group was treated with Solitaire AB stent thrombectomy combined with tirofiban and butylphthalide injection.The vascular recanalization,postoperative complications,death and neurological recovery were compared between the two groups,The serum levels of NSE,S100-β,TNF-α,IL-6 were compared between the two groups.
Results The recanalization of blood vessels was evaluated according to the TICI score grading standard,the rank sum test showed that there was significant difference between two groups (Hc=4.655,P=0.031).Chi square test showed that the recanalization rate of the combined group was slightly higher than that of the control group without significant difference (90.00% vs 83.33%,χ2=1.154,P=0.283).There was no significant difference in the incidence of postoperative symptomatic bleeding or pulmonary infection and the mortality between the two groups (all P>0.05).Compared with pre-operation,the NIHSS at 14 days after operation and modified Rankin score (mRS) at 3 months after operation of the two groups reduced,and they were significantly lower in combined group than those in control group(P< 0.05,P<0.01).Compared with pre-operation,the serum NSE,S100-β,TNF-α and IL-6 levels of the two groups significantly reduced at 14 days after the operation (all P<0.05),and they were significantly lower in combined group than those in control group (all P<0.01).
ConclusionSolitaire AB stent thrombectomy combined with tirofiban and butylphthalide injection is safe and effective in the treatment of ACI,which can improve the neurological function and the inflammatory reaction in the body effectively.
keywords: Acute cerebral infarction Solitaire AB stent Tirofiban Butylphthalide Neurological function Inflammatory factor
文章编号： 中图分类号： 文献标志码：B
基金项目:河北省医学科学研究重点课题(2018H055)
引用文本：