论文部分内容阅读
目的探讨阿替普酶溶栓疗法对老年急性脑梗死患者神经功能、颅内血流动力学、神经元特异性烯醇化酶(NSE)、中枢神经特异性蛋白(S-100β)含量及生活质量的影响。方法 120例老年急性脑梗死患者分为观察组(静脉溶栓治疗,n=60)和对照组(非静脉溶栓治疗,n=60),对照组给予常规治疗,观察组采用阿替普酶静脉溶栓治疗。比较两组治疗前后不同时间神经功能缺损程度、大脑中动脉(MCA)血流动力学变化、NSE和S-100β蛋白含量、残障水平及生活质量。结果治疗后3~28 d两组美国国立卫生研究院卒中量表(NIHSS)评分均呈逐渐降低趋势,且治疗后7~28 d观察组NIHSS评分明显低于对照组(P<0.05或P<0.01);治疗后1 h两组MCA收缩期峰值流速(Vp)、舒张末期流速(Vd)和平均流速(Vm)均明显增加,且观察组明显大于对照组(P<0.05或P<0.01);治疗后3~28 d两组NSE及S-100β蛋白含量均呈先升高后降低趋势,治疗后14~28 d观察组均明显低于对照组(P<0.01);经过3个月的治疗,观察组脑卒中专门化生存质量量表(SS-QOL)评分与对照组比较明显升高改良RANKIN量表(mRS)评分与对照组比较明显降低(P<0.05)。结论阿替普酶静脉溶栓可以明显增加老年急性脑梗死患者脑血流速度,降低NSE及S-100β蛋白含量,有效缓解患者神经功能缺损程度,进一步降低患者残障水平,对改善患者生活质量具有积极作用。
Objective To investigate the effects of alteplase thrombolytic therapy on neurological function, intracranial hemodynamics, neuron-specific enolase (NSE), central nervous system-specific protein (S-100β) content and quality of life in elderly patients with acute cerebral infarction Impact. Methods 120 elderly patients with acute cerebral infarction were divided into the observation group (intravenous thrombolytic therapy, n = 60) and the control group (non-intravenous thrombolysis, n = 60). The control group was given routine treatment. The observation group was treated with alteplase Intravenous thrombolysis. The degree of neurological deficits, hemodynamic changes of middle cerebral artery (MCA), protein content of NSE and S-100β, level of disability and quality of life were compared between the two groups before and after treatment. Results NIHSS scores decreased gradually in both groups from 3 to 28 days after treatment, and NIHSS scores in observation group were significantly lower than those in control group from 7 to 28 days after treatment (P <0.05 or P < 0.01). The peak systolic velocity (Vp), end-diastolic velocity (Vd) and mean velocity (Vm) of MCA in both groups were significantly increased at 1 h after treatment, and the observation group was significantly larger than the control group (P <0.05 or P <0.01) The protein content of NSE and S-100β in the two groups increased firstly and then decreased from the 3rd to 28th day after treatment. The observation group was significantly lower than the control group from 14 to 28 days after treatment (P <0.01); after 3 months The score of SS-QOL in treatment and observation group was significantly higher than that in control group. The mRS score of treatment group was significantly lower than that of control group (P <0.05). Conclusion Intraarterial thrombolysis with alteplase can significantly increase cerebral blood flow velocity, decrease NSE and S-100β protein in elderly patients with acute cerebral infarction, effectively relieve the degree of neurological deficits, further reduce the level of disability and improve the quality of life of patients positive effects.