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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

27卷

期数:

2021年06期

页码:

628-631,636

栏目:

临床医学

出版日期:

2021-11-15

文章信息/Info

Title:

Comparison of the effects of rt-PA alone or combined with heparin sodium on neurological function and oxidative stress levels in acute ischemic stroke

文章编号:

1006-8147（2021）06-0628-04

作者:

王笑寒; 张小林; 张保朝

（南阳市中心医院神经内科，南阳473000）

Author(s):

WANG Xiao-han; ZHANG Xiao-lin; ZHANG Bao-chao

（Department of Neurology，Nanyang Central Hospital，Nanyang 473000，China）

关键词:

急性缺血性脑卒中; rt-PA; 肝素钠; 氧化应激相关因子; 神经功能

Keywords:

acute cerebral infarction; rt-PA; heparin sodium; oxidative stress-related factors; nerve function

分类号:

R743.33

DOI:

-

文献标志码:

A

摘要:

目的：比较阿替普酶（rt-PA）单独或联合肝素钠治疗急性缺血性脑卒中对神经功能和氧化应激水平变化的影响。方法：收集2018年1月—2020年5月接受治疗的急性缺血性脑卒中患者126例。根据治疗方案的不同将患者分为对照组（rt-PA治疗，52例），观察组（rt-PA联合肝素钠治疗，74例）。分析两组患者治疗后的总有效率、氧化应激指标变化、神经功能指标变化、神经功能良好转归率和不良反应发生率。结果：与对照组（71.2%）相比，观察组总有效率为89.2%（χ2=6.657，P=0.010）。治疗后，与对照组相比，观察组超氧化物歧化酶（SOD）和谷胱甘肽过氧化物酶（GSH-px）水平升高（t=3.041，P=0.039；t=8.105，P<0.001），丙二醛（MDA）和氧化型低密度脂蛋白（ox-LDL）的水平降低（t=4.150，P=0.009；t=10.207，P<0.001）；美国国立卫生研究院卒中量表（NIHSS ）评分和S100B（S100钙结合蛋白B）蛋白水平降低（t=5.414，P<0.001；t=3.115，P=0.031），脑源性神经营养因子（BDNF）水平升高（t=3.052，P=0.041）；改良Rankin量表（mRS）评分降低（t=3.043，P=0.045）。与对照组相比，观察组神经功能转归良好率较高（χ2=4.090，P=0.043），不良反应率差异无统计学意义（P>0.05）。结论：rt-PA联合肝素钠与rt-PA单独治疗急性缺血性脑卒中相比，临床疗效显著，可有效改善氧化应激指标水平和神经功能，且未增加患者的不良反应。

Abstract:

Objective： To compare the effects of alteplase（rt-PA） alone or combined with heparin sodium on the changes of nerve function and oxidative stress in the treatment of acute ischemic stroke. Methods： A total of 126 patients with acute cerebral infarction who were treated in Nanyang Central Hospital from January 2018 to May 2020 were collected. Patients were divided into control group（rt-PA treatment，52 cases） and observation group（rt-PA combined with heparin sodium treatment，74 cases） according to different treatment options. The total effective rate，changes in oxidative stress indexes，changes in neurological function indexes，good neurological function outcomes and incidence of adverse reactions were analyzed after treatment in both groups. Results：Compared with the control group（71.2%），the total effective rate of the observation group was 89.2%（χ2=6.657，P=0.010）. After treatment，compared with the control group，the levels of superoxide dismutase（SOD） and glutathione peroxidase（GSH-px） in the observation group increased（t=3.041，P=0.039；t=8.105，P<0.001），the levels of malondialdehyde（MDA） and oxidized low-density lipoprotein（ox-LDL） decreased（t=4.150，P=0.009；t=10.207，P<0.001），the National Institutes of Health Stroke Scale（NIHSS） score and S100B （S100 calcium binding protein B） protein levels decreased（t=5.414，P<0.001；t=3.115，P=0.031），brain-derived neurotrophic factor（BDNF） level increased（t=3.052，P=0.041），modified Rankin Scale （mRS） score decreased（t=3.043，P=0.045）. Compared with the control group，the observation group had a higher neurological function outcome rate（χ2=4.090，P=0.043），and the difference in the adverse reaction rate was not statistically significant（P>0.05）. Conclusion： Compared with rt-PA in the treatment of acute cerebral infarction，rt-PA combined with heparin sodium has a significant clinical effect，which can effectively improve the level of oxidative stress indicators and nerve function，and does not increase the adverse reactions of patients.

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相似文献/References:

[1]姜博,周娟.时间目标管理在急性缺血性脑卒中静脉溶栓中的临床应用[J].天津医科大学学报,2025,31(01):67.[doi:10.20135/j.issn.1006-8147.2025.01.0067]
　JIANG Bo,ZHOU Juan.Clinical application of time target management in intravenous thrombolysis in acute ischemic stroke[J].Journal of Tianjin Medical University,2025,31(06):67.[doi:10.20135/j.issn.1006-8147.2025.01.0067]

备注/Memo

备注/Memo:

基金项目 河南省医学科技攻关计划（2018020174） 作者简介 王笑寒(1988-)，女，主治医师，硕士，研究方向：脑血管病; E-mail: huangjingg123@163.com。

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更新日期/Last Update: 2021-11-15