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rt-PA静脉溶栓联合介入治疗对急性缺血性脑卒中患者MRS评分、Barthel指数、脑部血流动力学的影响.pdf
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rt PA 静脉 联合 介入 治疗 急性 缺血性 脑卒中 患者 MRS 评分 Barthel 指数 脑部 血流 动力学 影响
临床和实验医学杂志2 0 2 3年8 月第2 2 卷第15期8Feng J,Ouyang H,Wang J,et al.MPZLI upregulation promotes tumormetastasis and correlates with unfavorable prognosis in non-small celllung cancerJ.Carcinogenesis,2022,43(10):919-929.9 7Zhou C,Chen Z,Zhao L,et al.A novel circulating miRNA-,basedsignature for the early diagnosis and prognosis prediction of non-small-cell lung cancerJ.J Clin Lab Anal,2020,34(11):e23505.10Visan KS,Lobb RJ,Wen SW,et al.Blood-Derived ExtracellularVesicle-Associated miR-3182 Detects Non-Small Cell Lung CancerPatientsJ.Cancers,2022,14(1):257-263.11】张吉瑞,汤佳琦,夏铀铀.miRNA在非小细胞肺癌诊断和治疗中的研究进展J癌症进展,2 0 2 0,18(1):4-7,2 5.12 Wang J,Mo J,Xie Y,et al.Ultrasound microbubbles-mediated miR-216b affects MALAT1-miRNA axis in non-small cell lung cancercellsJ.Tissue Cell,2022,74(11):101703-101715.13韩云,毛宇强,徐然,等miR-214与MIR31HG在非小细胞肺癌中的表达及其临床意义J疑难病杂志,2 0 19,18(10:10 17-10 2 1.:158314黄俊谦,王鹏,徐美华,等MiR-151a-5p表达与晚期非小细胞肺癌患者病理特征、化疗效果的相关性及潜在靶基因的探究J.临床和实验医学杂志,2 0 2 0,19(19):2 0 57-2 0 6 0.15石锋,刘向前,郭苹微小RNA-146-5p靶向Notch2对非小细胞肺癌增殖、调亡和侵袭的影响J中华实验外科杂志,2 0 2 2,39(11):2169-2172.16】林方梁,张杰,曾丽霞,等.lncRNAFOXD2-AS1靶向miR-1299抑制口腔鳞癌细胞增殖和诱导调亡的体外研究J河北医药,2022,44(9):1312-1315,1320.17陈秀迎,王洪远,miR-19a-3p靶向调控CCND1基因介导FrA-1/IL-6/Stat3信号通路对乳腺癌侵袭转移的作用机制J.武警医学,2 0 19,30(8):6 57-6 6 1.18 雷坤阳,谢文杰,孙庭,等MiR-744-5p通过靶向CCND1抑制肾透明细胞癌细胞的增殖、侵袭和迁移J南方医科大学学报,2022,42(5):712-717.(收稿日期:2 0 2 3-0 2-19D0I:10.3969/j.issn.1671-4695.2023.15.004rt-PA静脉溶栓联合介入治疗对急性缺血性脑卒中患者MRS 评分、Barthel指数、脑部血流动力学的影响蒋云秋刘健赵丹郑光宇丨何丰(宜宾市第一人民医院1急诊科;2 神经内科四川宜宾6 440 0 0)【摘要】目的探究重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓联合介入治疗对急性缺血性脑卒中(AIS)患者的影响。方法前瞻性选取2 0 2 1年1月至2 0 2 2 年6 月宜宾市第一人民医院收治的AIS患者10 6 例作为研究对象,按随机数字表法将其分为对照组和观察组,各53例。对照组给予rt-PA进行静脉溶栓治疗,观察组在对照组的基础上进行介入治疗。比较两组的临床疗效;比较两组患者治疗前、治疗后2 4 h、治疗后3个月的美国国立卫生研究院卒中量表(NIHSS)评分,治疗前、治疗后3个月的改良Rankins量表(MRS)评分、Barthel指数、大脑中动脉(MCA)、大脑前动脉(A C A)、基底动脉(BA)的平均血流速度;并记录治疗后3个月内发生的不良反应以及病死率。结果观察组总有效率为8 8.6 8%,高于对照组(7 3.58%),差异有统计学意义(P0.05)。治疗后2 4h、治疗后3个月,两组患者的NIHSS评分均较治疗前均降低,且观察组分别为(6.37 1.2 4)、(2.6 7 1.11分,均低于对照组(7.2 51.36)、(3.6 31.54)分,差异均有统计学意义(P0.05)。治疗后3个月,两组MRS评分较治疗前降低,Barthel 指数分数较治疗前升高,且观察组MRS评分为(1.9 8 0.2 1)分,低于对照组(2.56 0.34)分,Barthel指数分数为(8 7.12 6.8 1)分,高于对照组(7 1.336.54)分,差异均有统计学意义(P0.05)。治疗后3个月,两组MCA、A C A、BA 的平均血流速度均高于治疗前,且观察组分别为(6 0.6 55.9 6)、(43.2 45.36)、(39.8 6 5.36)cm/s,均高于对照组(52.336.14)、(38.415.84)、(34.6 8 5.7 2)c m/s ,差异有统计学意义(P0.05)。观察组不良反应率为9.43%,低于对照组(2 4.53%),差异有统计学意义(P0.05)。结论rt-PA静脉溶栓联合介入治疗有利于AIS患者神经功能恢复,有利于患者生活质量以及日常生活能力的提高,促进脑血流动力学的改善,并能减少不良反应的发生,值得临床推广应用。【关键词】急性缺血性脑卒中静脉溶栓改良Rankins量表脑部血流动力学Barthel指数Effects of rt-PA intravenous thrombolysis combined with interventional therapy on MRS score,Barthel index and cerebral hemody-namics in acute isohemic stroke patients.JIANG Yun-qiu,LIU Jian,ZHAO Dan,et al.Department of Emergency,Yibin First Peoples Hospi-tal,Yibin Sichuan 644000,China.【A b s t r a c t)O b j e c t i v e T o e x p l o r e t h e e f f e c t o f i n t r a v e n o u s t h r o m b o l y s i s w i t h r e c o m b i n a n t t i s s u e p l a s m i n o g e n a c t i v a t o r (r t -PA)c o m-bined with interventional therapy on patients with acute ischemic stroke(AIS).Methods A prospective study was conducted on 106 AIS patientstreated in Yibin First Peoples Hospital from January 2021 to June 2022.They were divided into the control group and the observation group accord-ing to random number table method,with 53 patients in each group.Both groups underwent rt-PA intravenous thrombolysis,and the observationgroup underwent interventional therapy on this basis.The curative effect was compared between the two groups.The national institutes of healthstroke scale(NIHSS)scores before treatment,24 hours after treatment,and 3 months after treatment were compared between the two groups.Themodified Rankins scale(MRS),Barthel index scores,mean blood flow velocity of the middle cerebral artery(MCA),anterior cerebral artery(ACA),and basilar artery(BA)before and 3 months after treatment were compared between the two groups;and the adverse reactions and mor-基金项目:四川省卫生厅课题(编号:17 PJ10206)文章编号:16 7 1-46 9 5(2 0 2 3)15-158 3-0 4:1584:tality rate that occurred within 3 months after treatment were recorded.Results The total effective rate of the observation group was 88.68%,higher than that of the control group(73.58%),the difference was statistically significant(P 0.05).After 24 hours and 3 months of treat-ment,the NIHSS scores of two groups were lower than those before treatment,and those of the observation group were(6.37+1.24)and(2.671.11)scores,respectively,which were lower than those of the control group(7.25 1.36)and(3.63 1.54)scores,the differenceswere statistically significant(P 0.05).After 3 months of treatment,the MRS scores of the two groups were lower than those before treatment,while the Barthel index scores were higher than those before treatment,MRS score of the observation group was(1.98+0.21)points,which waslower than that of the control group(2.56 0.34)points,and the Barthel index score was(87.12 6.81)points,which was higher than thatof the control group(71.33 6.54)points,th

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