神经保护剂辅助早期静脉溶栓治疗急性脑梗死临床观察
杨 倩 邓明珠
湖南省脑科医院，湖南 长沙 410002
通信作者：杨倩，Email：yyangqian1228@163.com
【摘要】 目的 探讨神经保护剂辅助早期静脉溶栓治疗对急性脑梗死(ACI )患者血清同型半胱氨酸 (Hcy)、纤维蛋白原( FIB )水平的影响。方法 选取湖南省脑科医院收治的112 例 ACI 患者为研究对象， 溶栓组和实验组各 56 例。溶栓组采用阿替普酶进行早期静脉溶栓治疗，实验组在溶栓组的基础上联合 神经保护剂治疗。 比较 2 组疗效，观察治疗前后 2 组血清 Hcy 和 FIB 水平、神经功能缺损程度和血液流变学变化 。结果 实验组总有效率(92.86%)明显高于溶栓组(78.57% ，P<0.05)。 实验组治疗 1 d、14 d 后 改良爱丁堡-斯堪的维纳亚量表( MESSS )评分明显高于溶栓组(P<0.05)；2 组治疗后血清 Hcy 和 FIB 水平 明显低于治疗前(P<0.05 )，实验组低于溶栓组(P<0.05 )。 2 组治疗后血浆黏度、血液黏度、还原黏度、红 细胞比积以及血栓形成系数均明显低于治疗前(P<0.05)，实验组低于溶栓组(P<0.05)。 结论 ACI 患者 采用神经保护剂辅助早期溶栓治疗能有效提高疗效，改善 Hcy、FIB 水平以及血液流变学变化，降低神经 损伤程度。
【关键词】 急性脑梗死；早期静脉溶栓；神经保护剂；神经功能缺损程度；血液流变学
【中图分类号】 R743.33 【文献标识码】 A 【文章编号】 1673-5110 ( 2022 ) 01-0001-05
基金项目：湖南省卫生健康委科研计划项目(编号：20201642 )
Clinical observation of neuroprotective agent assisted early intravenous thrombolysis in the treatment of acute cerebral infarction
YANG Qian，DENG Mingzhu
Hunan Brain Hospital，Changsha 410002，China
Corresponding author：YANG Qian，Email：yyangqian1228@163.com
【Abstract】 Objective To investigate the effect of neuroprotective agent assisted early intravenous thrombolysis on the levels of serum homocysteine (Hcy) and fibrinogen (FIB ) in patients with acute cerebral infarction (ACI ). Methods Totally112 patients with ACI treated in our hospital were selected as the research objects. They were divided into thrombolysis group and experimental group，with 56 cases in each group. The thrombolytic group was treated with alteplase for early intravenous thrombolysis，and the experimental group was treated with neuroprotective agents on the basis of thrombolytic group. The curative effects of the two groups were compared. Changes of Hcy and FIB levels，degree of nerve defect and hemorheology before and after treatment were observed. Results The total effective rate of the experimental group (92.86%) was significantly higher than that of the thrombolytic group (78.57%) (P<0.05 ). After 1 day and 14 days of treatment，the MESSS score in the experimental group was significantly higher than that in the thrombolytic group (P < 0.05 ). After treatment，Hcy and FIB levels in the two groups were significantly lower than those before treatment (P<0.05 )，and those in the experimental group were lower than those in the thrombolytic group (P<0.05). After treatment，the plasma viscosity，blood viscosity，reducing viscosity，hematocrit and thrombosis coefficient in the two groups were significantly lower than those before treatment (P<0.05 )，and those in the experimental group were lower than those in the thrombolytic group (P<0.05 ). Conclusion Early thrombolysis assisted by neuroprotective agents in patients with ACI can effectively improve the curative effect，improve the level of Hcy，FIB index and hemorheological changes，and re⁃ duce the degree of nerve injury.
【Key words】 Acute cerebral infarction；Early intravenous thrombolysis；Neuroprotective agents；Degree of nerve defect