| 郭绮倩,吴秀芹,贺 巍,刘付有欢,李小露.阿替普酶联合阿加曲班对急性缺血性脑卒中患者内皮损伤、血液流变学和神经功能损伤因子的影响[J].,2022,(13):2483-2487 |
| 阿替普酶联合阿加曲班对急性缺血性脑卒中患者内皮损伤、血液流变学和神经功能损伤因子的影响 |
| Effects of Alteplase Combined with Argatroban on Endothelial Injury, Hemorheology and Nerve Function Injury Factors in Patients with Acute Ischemic Stroke |
| 投稿时间：2022-01-18 修订日期：2022-02-14 |
| DOI：10.13241/j.cnki.pmb.2022.13.016 |
| 中文关键词: 阿替普酶 阿加曲班 急性缺血性脑卒中 内皮损伤 血液流变学 神经功能 |
| 英文关键词: Alteplase Agatraban Acute ischemic stroke Endothelial injury Hemorheology Nerve function |
| 基金项目:广东省医院药学研究基金项目（2017A12） |
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| 摘要 目的：探讨阿替普酶联合阿加曲班治疗急性缺血性脑卒中（AIS）对患者内皮损伤、血液流变学和神经功能损伤因子的影响。方法：采用随机数字表法，将南方医科大学珠江医院神经内科2019年8月~2021年7月期间收治的94例AIS患者分为对照组（n=47）和研究组（n=47）。对照组患者接受阿替普酶治疗，研究组患者接受阿替普酶联合阿加曲班治疗，对比两组疗效、内皮损伤指标、血液流变学指标、神经功能损伤因子、美国国立卫生研究所卒中量表（NIHSS）评分、Barthel指数（BI）评分和不良反应。结果：与对照组治疗后相比，研究组治疗后的临床总有效率更高（P<0.05）。与对照组治疗后相比，研究组治疗后内皮素-1（ET-1）水平更低，降钙素基因相关肽（CGRP）、一氧化氮（NO）水平更高（P<0.05）。与对照组治疗后相比，研究组治疗后血浆黏度（PV）、全血黏度（WBV）、红细胞压积（HCT）、纤维蛋白原（FIB）水平更低（P<0.05）。与对照组治疗后相比，研究组治疗后神经元特异性烯醇化酶（NSE）、S100β蛋白水平更低（P<0.05）。与对照组治疗后相比，研究组治疗后NIHSS评分更低，BI评分更高（P<0.05）。两组不良反应发生率组间对比无差异（P>0.05）。结论：阿替普酶联合阿加曲班应用于AIS患者，可改善机体血液流变学，减轻内皮功能损伤和神经功能损害。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of alteplase combined with argatroban on endothelial injury, hemorheology and nerve function injury factors in patients with acute ischemic stroke(AIS). Methods: 94 patients with AIS who were treated in the Department of Neurology, Zhujiang Hospital of Southern Medical University from August 2019 to July 2021 were randomly divided into control group(n=47) and study group(n=47). Patients in the control group were treated with alteplase and patients in the study group were treated with alteplase combined with argatroban. The efficacy, endothelial injury index, hemorheological index, neurological injury factors, national Institutes of Health Stroke Scale (NIHSS) score, Barthel Index (BI) score and adverse reactions were compared between the two groups. Results: Compared with the control group, the total clinical effective rate of the study group was higher after treatment (P<0.05). Compared with the control group, endothelin-1(ET-1) was lower, calcitonin gene-related peptide (CGRP) and nitric oxide (NO) were higher in the study group(P<0.05). Compared with the control group, the plasma viscosity(PV), whole blood viscosity (WBV), hematocrit (HCT) and fibrinogen (FIB) in the study group were lower after treatment (P<0.05). Compared with the control group, Neuron specific enolase(NSE) and S100β after treatment in the study group was lower(P<0.05). Compared with the control group, The NIHSS score was lower and the BI score was higher in the study group after treatment(P<0.05). There was no difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion: The application of alteplase combined with argatroban in patients with AIS can improve hemorheology and reduce the damage of endothelial function and nerve function. |
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