目的 观察对急性脑梗死(ACI)患者使用替奈普酶(TNK)静脉溶栓并且联合丁苯酞注射液治疗的临床疗效。方法 选取2024-01至2025-03武警特色医学中心收入住院的60例ACI患者,将其随机分为对照组与联合治疗组,每组各30例。均给予两组患者基础治疗,同时给予对照组患者TNK静推静脉溶栓,联合治疗组患者在TNK静脉溶栓的基础上联合丁苯酞注射液治疗,比较两组患者治疗前后改良Rankin量表(mRS)评分、血清炎症因子水平及不良反应发生情况,以及在入院时、溶栓后24 h、7 d及90 d的美国国立卫生研究院卒中量表(NIHSS)评分情况。结果 两组患者治疗前mRS评分及血清炎症因子水平差异无统计学意义(P＞0.05),联合治疗组患者治疗后mRS评分为(1.30±0.47)分,对照组为(2.40±0.50)分,联合治疗组低于对照组,差异有统计学意义(P<0.05);联合治疗组患者血清炎症因子IL-6、IL-8、IL-10水平分别为(20.13±3.47)ng/L、(19.33±3.56)ng/L及(8.34±0.38)ng/L,对照组则分别为(24.32±3.61)ng/L、(22.48±3.83)ng/L及(9.29±0.64)ng/L,联合治疗组低于对照组,差异有统计学意义(P<0.05);两组患者在入院时及溶栓后24 h NIHSS评分无明显差异(P＞0.05),而联合治疗组患者在溶栓后7 d NIHSS评分为(11.63±1.56)分,对照组为(13.13±1.63)分,联合治疗组低于对照组,差异有统计学意义(P<0.05);联合治疗组患者溶栓后90 d NIHSS评分为(8.47±1.07)分,对照组为(9.57±1.22)分,联合治疗组低于对照组,差异有统计学意义(P<0.05);两组患者在治疗后的不良反应发生率无明显差异(P＞0.05)。结论 对ACI患者给予TNK静脉溶栓联合丁苯酞注射液治疗可促进神经功能的恢复,降低血清炎症因子水平,无明显不良反应,安全有效。
Abstract
Objective To explore the clinical efficacy of tenecteplase (TNK) intravenous thrombolysis combined with butylphthalide injection in the patients with acute cerebral infarction (ACI). Methods A total of 60 patients with ACI admitted to Characteristics Medical Center of Chinese People’s Armed Police Force from January 2024 to March 2025 were selected and randomly divided into a control group and a combined treatment group, with 30 patients in each group. Both groups were given the same basic treatment, and the control group was treated with TNK intravenous thrombolysis, while the combined treatment group was treated with TNK intravenous thrombolysis combined with butylphthalide injection. The modified Rankin scale (mRS) scores, serum inflammatory factor levels and adverse reactions were compared before and after treatment between the two groups, and the National Institutes of Health stroke scale (NIHSS) was used to assess the scores of the patients at admission, 24 h, 7 d, and 90 d after thrombolysis. Results There were no significant differences between the combined treatment group and the control group in mRS score and the levels of serum inflammatory factors at admission(P>0.05). The mRS score of the combined treatment group after treatment (1.30±0.47 points) was lower than that of the control group (2.40±0.50 points), with a statistically significant difference (P<0.05). The levels of serum inflammatory factors IL-6, IL-8, and IL-10 in the combined treatment group were (20.13±3.47) ng/L, (19.33±3.56) ng/L, and (8.34±0.38) ng/L, respectively, which were lower than (24.32±3.61) ng/L, (22.48±3.83) ng/L, and (9.29±0.64) ng/L, respectively in the control group, with a statistically significant difference (P<0.05); There were no significant differences between the combined treatment group and the control group in NIHSS scores at admission and 24 h after thrombolysis (P>0.05), but the NIHSS score of patients in the combined treatment group was (11.63±1.56) points 7 d after thrombolysis, which was lower than (13.13±1.63) points of the control group, with a statistically significant difference (P<0.05). The NIHSS score of patients in the combined treatment group was (8.47±1.07) points 90 d after thrombolysis, which was lower than (9.57±1.22) points of the control group, with a statistically significant difference (P<0.05).The incidence of adverse reactions in the combined treatment group compared to the control group showed no significant difference (P>0.05). Conclusions TNK intravenous thrombolysis combined with butylphthalide injection can improve the recovery of neurological dysfunction and reduce the levels of serum inflammatory factors of patients with ACI, without obvious adverse reactions, which is a safe and effective treatment method.
关键词
替奈普酶 /
丁苯酞 /
急性脑梗死 /
静脉溶栓 /
临床疗效
Key words
tenecteplase /
butylphthalide /
acute cerebral infarction /
intravenous thrombolysis /
clinical efficacy
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基金
天津市医学重点学科建设资助(TJYXZDXK-3-001D)
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