rt-PA静脉溶栓联合丁苯酞静脉注射治疗急性脑梗死临床研究

蒋大明

[摘要] 目的 探討急性脑梗死应用rt-PA静脉溶栓联合丁苯酞静脉注射治疗的临床疗效。 方法 将2018年1月至2020年6月我院收治的60例急性脑梗死患者通过计算机随机填表法分为研究组与对照组，两组各纳入30例，两组患者入院后立即展开吸氧、抗血小板及输液等常规治疗，给予对照组患者实施rt-PA静脉溶栓治疗，研究组在对照组基础上联合丁苯酞静脉注射，对比两组患者临床疗效、NHISS评分、Barthel指数、血清炎症指标及不良反应。 结果 研究组临床总有效率明显高于对照组，NHISS评分低于对照组，Barthel指数高于对照组，hs-CRP、TNF-α及IL-6水平均低于对照组，差异有统计学意义（P<0.05）;两组患者不良反应总发生率比较，差异无统计学意义（P>0.05）。 结论 急性脑梗死应用rt-PA静脉溶栓联合丁苯酞静脉注射治疗效果显著，能有效降低血清炎症水平，改善神经功能，提高生活活动能力，值得应用推广。

[关键词] rt-PA;丁苯酞;急性脑梗死;静脉溶栓;临床疗效

[中图分类号] R743.33          [文献标识码] B          [文章编号] 1673-9701（2021）30-0100-03

[Abstract] Objective To investigate the clinical effect of intravenous thrombolysis with rt-PA combined with intravenous butylphthalide in the treatment of acute cerebral infarction. Methods A total of 60 patients with acute cerebral infarction who were admitted to our hospital from January 2018 to June 2020 were randomly divided into the study group and the control group by the computer random form filling method， with 30 patients in each group. Patients in the two groups were immediately treated with oxygen inhalation， antiplatelet and infusion after admission. Patients in the control group were treated with？intravenous thrombolysis with rt-PA， and patients in the study group were combined with intravenous butylphthalide on the basis of the control group. The clinical efficacy， NHISS scores， Barthel indexes， serum inflammatory indexes and adverse reactions in the two groups were compared. Results The clinical total effective rate of the study group was significantly higher than that of the control group; the NHISS score of the study group was lower than that of the control group; the Barthel index of the study group was higher than that of the control group; the level of hs-CRP， TNF-α and IL-6 of the study group were lower than that of the control group; the differences were statistically significant （P<0.05）.There was no significant difference in the total incidence of adverse reactions between the two groups （P>0.05）. Conclusion Intravenous thrombolysis with rt-PA combined with intravenous butylphthalide in the treatment of acute cerebral infarction has a significant therapeutic effect， which can effectively reduce the serum inflammatory level， improve neurological function， and enhance the ability of living activities. Therefore， it is worthy of application and promotion.

[Key words] rt-PA; Butylphthalide; Acute cerebral infarction; Intravenous thrombolysis; Clinical efficacy

急性脑梗死在脑血管疾病中属于常见疾病，多发于中老年人群，其特点是发病急且病情危重，通常临床表现为认知功能异常、意识模糊、偏瘫、感觉异常、丧失语言及运动功能等症状，该疾病具有较高的致残率和病死率，严重威胁患者的生命安全[1-2]。早期展开静脉溶栓是治疗急性脑梗死的关键，阿替普酶（Recombinant tissue plasminogen activator，rt-PA）是临床应用较多的血栓溶解药物，通过该药物溶栓可将患者堵塞的血管迅速疏通，改善机体微循环，促进血液再灌注，恢复缺血区域血液共济，重新激活脑细胞，进而控制病情发展，改善神经功能[3-4]。……