阿替普酶溶栓治疗对老年急性脑梗死患者神经功能、颅内血流动力学及生活质量的影响

发布时间：2018-12-09 12:44

【摘要】：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(P0.05或P0.01);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(P0.05或P0.01);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(P0.01);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(P0.05)。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。
[Abstract]:Objective to investigate the effects of atropase thrombolytic therapy on neurological function, intracranial hemodynamics, neuron-specific enolase (NSE), central nervous system specific protein (S-100 尾) and quality of life (QOL) in elderly patients with acute cerebral infarction. Methods 120 elderly patients with acute cerebral infarction were divided into observation group (intravenous thrombolytic therapy, nong60) and control group (non-venous thrombolytic therapy, nong60). The control group was treated with routine therapy, and the observation group was treated with intravenous thrombolytic therapy with atropine. The changes of (MCA) hemodynamics, the contents of NSE and S-100 尾 protein, the level of disability and the quality of life were compared between the two groups before and after treatment. Results the (NIHSS) score of the stroke scale of the National Institutes of Health in the two groups decreased gradually at 3 to 28 days after treatment, and the NIHSS score of the observation group was significantly lower than that of the control group on the 7th day after treatment (P0.05 or P0.01). At 1 hour after treatment, the peak systolic velocity of MCA, (Vp), end-diastolic velocity (Vd) and mean flow velocity (Vm) were significantly increased in both groups, and the value of (Vd) in the observation group was significantly higher than that in the control group (P0.05 or P0.01). The contents of NSE and S-100 尾 protein in the two groups increased first and then decreased on the 3rd and 28th day after treatment, and were significantly lower in the observation group than in the control group at 1428 days after treatment (P0.01). After 3 months of treatment, the scores of SS-QOL in the observation group were significantly higher than those in the control group, and the (mRS) score of the modified RANKIN scale was significantly lower than that of the control group (P0.05). Conclusion intravenous thrombolysis with atropine can significantly increase the cerebral blood flow velocity, decrease the contents of NSE and S-100 尾 protein, alleviate the degree of neurological impairment and further decrease the disability level of the elderly patients with acute cerebral infarction. It plays a positive role in improving the quality of life of patients.
【作者单位】：白银市第一人民医院神经内科;甘肃省人民医院脑血管病中心;
【分类号】：R743.33

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