急性后循环脑梗死静脉溶栓联合人尿激肽原酶治疗后血清VEGF、MMP-9变化的临床研究

发布时间：2018-12-23 09:10

【摘要】：目的探讨急性后循环脑梗死静脉溶栓后联合人尿激肽原酶治疗的安全性及有效性,观察治疗后血清VEGF、MMP-9水平的变化。方法采用随机平行对照研究,以急性后循环脑梗死患者为研究对象,以rt-PA静脉溶栓联合人尿激肽原酶为联合治疗组,单纯静脉溶栓治疗为对照组,采用NIHSS、mRS量表评价临床疗效;以酶联免疫吸附法检测不同治疗时间VEGF、MMP-9的水平。结果联合治疗组及对照组NIHSS治疗前后均有统计学差异(P0.05)。联合治疗组与对照组治疗后90 d的BI评分及治疗后30 d和90 d的mRS评分均有统计学差异(P0.05)。联合治疗组较对照组在治疗后不同时间,VEGF均有不同程度升高;MMP-9随治疗时间延长呈下降趋势。结论 rt-PA静脉溶栓联合人尿激肽原酶的方法在临床上是安全的,并能显著改善神经功能的缺损。其可能机制除早期开通血管外,还可能通过调节VEGF、MMP-9的水平,促进侧支循环的建立。
[Abstract]:Objective to investigate the safety and efficacy of intravenous thrombolytic therapy combined with human urinary kallikrein in patients with acute posterior circulation cerebral infarction (ARCI), and to observe the changes of serum VEGF,MMP-9 levels after treatment. Methods A randomized parallel controlled study was conducted in patients with acute posterior circulation cerebral infarction. Rt-PA intravenous thrombolytic therapy combined with human urinary kallikrein was used as the combined treatment group and intravenous thrombolytic therapy was used as the control group. NIHSS, was used as the control group. MRS scale was used to evaluate the clinical efficacy. Enzyme linked immunosorbent assay (Elisa) was used to detect the level of VEGF,MMP-9 at different treatment time. Results there were significant differences between the combined treatment group and the control group before and after NIHSS treatment (P0.05). The BI scores of the combined treatment group and the control group were significantly different from those of the control group at 90 days after treatment and 30 and 90 days after treatment (P0.05). Compared with the control group, the VEGF of the combined treatment group increased in different degrees, and the MMP-9 decreased with the prolongation of the treatment time. Conclusion rt-PA intravenous thrombolysis combined with human urinary kallikrein is safe in clinical practice and can significantly improve nerve function defect. In addition to the early opening of blood vessels, the mechanism may also promote the establishment of collateral circulation by regulating the level of VEGF,MMP-9.
【作者单位】：深圳市罗湖医院集团湖贝社区健康服务中心;北京大学深圳医院神经内科;
【基金】：深圳市卫计委科研项目(201302074) 深圳市科创委科研项目(JYCJ20140415162338844)
【分类号】：R743.33

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