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目的探讨阿替普酶静脉溶栓对轻中度急性缺血性脑卒中患者血清炎性因子、同型半胱氨酸(Hcy)水平的影响及其相关性分析。方法选取柳州市工人医院2014年12月—2016年6月收治的轻中度急性缺血性脑卒中患者124例,按照随机数字表法分为对照组和试验组,各62例。对照组患者给予常规对症治疗,试验组患者在对照组基础上给予阿替普酶静脉溶栓治疗。比较两组患者的临床疗效,治疗前后血清炎性因子[白介素6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)]、同型半胱氨酸(Hcy)水平变化情况,并分析美国国立卫生研究院卒中量表(NIHSS)评分与IL-6、Hcy的相关性。结果试验组患者临床治疗总有效率高于对照组(P<0.05)。治疗前,两组患者血清IL-6、CRP、TNF-α、Hcy水平比较,差异无统计学意义(P>0.05);治疗后,试验组患者血清IL-6、CRP、TNF-α、Hcy水平低于对照组(P<0.05)。NIHSS评分与IL-6、Hcy呈正相关(r=0.688、0.569,P<0.05)。结论采用阿替普酶静脉溶栓治疗轻中度急性缺血性脑卒中的临床疗效确切,可有效改善患者血清炎性因子及Hcy水平,且患者NIHSS评分与血清IL-6、Hcy呈正相关。
Objective To investigate the effect of alteplase intravenous thrombolysis on the levels of serum inflammatory cytokines and homocysteine (Hcy) in mild to moderate acute ischemic stroke patients and its correlation analysis. Methods A total of 124 patients with mild-to-moderate acute ischemic stroke admitted to Liuzhou Workers Hospital from December 2014 to June 2016 were randomly divided into control group and experimental group according to random number table. Patients in the control group were given conventional symptomatic treatment. Patients in the test group were treated with intravenous infusion of alteplase on the basis of the control group. The clinical efficacy of two groups of patients was compared. Serum levels of inflammatory cytokines (interleukin 6, CRP, TNF-α, Hcy) And analyzed the NIH Stroke Scale (NIHSS) score and IL-6, Hcy correlation. Results The total effective rate of clinical trial in trial group was higher than that in control group (P <0.05). Before treatment, the serum levels of IL-6, CRP, TNF-α and Hcy in the two groups had no significant difference (P> 0.05). After treatment, the levels of IL-6, CRP, The level was lower than the control group (P <0.05). The NIHSS score was positively correlated with IL-6 and Hcy (r = 0.688, 0.569, P <0.05). Conclusions Alteplase intravenous thrombolysis in the treatment of mild to moderate acute ischemic stroke has definite curative effect, which can effectively improve the level of serum inflammatory cytokines and Hcy, and the NIHSS score is positively correlated with serum IL-6 and Hcy.