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| 阿替普酶静脉溶栓联合丁苯酞注射液治疗急性脑卒中的临床疗效 |
| Effect of alteplase combined with butyphthalide onpatients with acute ischemic stroke |
| 投稿时间：2020-05-10 |
| DOI：10.3969/j.issn.1000-0399.2020.11.027 |
| 中文关键词: 阿替普酶 丁苯酞 急性脑卒中 临床疗效 美国国立卫生研究院卒中量表得分 改良后的Rankin量表得分 |
| 英文关键词: Alteplase Butyphthalide Acute ischemic stroke Clinical efficacy National Institutes of Health stroke scale Modified Rankin scale |
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| 中文摘要: |
| 目的 探讨阿替普酶静脉溶栓联合丁苯酞注射液治疗急性脑卒中(AIS)的临床疗效。方法 选取安徽省庐江县人民医院2017年1月至2019年11月收治的55例AIS患者作为研究对象,采用随机数字表法将其分为研究组(27例)与对照组(28例)。在常规治疗的基础上,对照组采用阿替普酶静脉溶栓治疗,研究组采用阿替普酶静脉溶栓联合丁苯酞治疗。采用广义估计方程(GEE)比较两组患者治疗后美国国立卫生研究院卒中量表(NIHSS)和改良后的Rankin量表(mRS)的得分差异。结果 治疗前,两组患者NIHSS得分比较,差异无统计学意义(P>0.05)。研究组患者治疗第24小时与第7天的平均NIHSS得分均低于对照组,差异有统计学意义(P<0.05)。研究组患者治疗第24小时与第7天的平均mRS得分均低于对照组,且治疗第7天的差异有统计学意义(P<0.05)。不同治疗方案和时间对NIHSS得分无交互作用(P=0.189),但对mRS得分有交互作用(P=0.033)。GEE模型显示,与对照组相比,研究组患者治疗第24小时与第7天的NIHSS得分平均降低3.071(95%置信区间:-5.280～-0.862;P=0.006),mRS得分平均降低1.190(95%置信区间:-1.953～-0.428;P=0.002)。结论 阿替普酶静脉溶栓联合使用丁苯酞能有效改善AIS患者神经功能缺损症状,提高临床疗效。 |
| 英文摘要: |
| Objective To explore the effect of alteplase combined with butyphthalide on the patients with acute ischemic stroke (AIS). 参考文献 周立波, 韩祥翠, 王健平, 等. ProTaper Next、S3和Reciproc根管预备系统对弯曲根管成形能力的比较. 牙体牙髓牙周病学杂志, 2018, 28(7):390-394. 王丹, 王璟, 马立亚. 不同镍钛机动器械进行牙髓炎根管治疗的效果观察. 河北医药, 2019, 41(13):1989-1992. 于小青, 刘宇飞, 郭世博, 等. 5种机用镍钛锉预备根管成形能力的比较研究. 口腔医学研究, 2017, 33(3):286-289. 宋鑫, 蔡琴, 张凤格, 等. 2种机用镍钛器械磨牙根管预备效果的临床观察. 口腔医学, 2018, 38(11):988-990, 994. ARSLAN H, DOG∨ANAY E, KARATAŞ E, et al. Effect of low-level laser therapy on postoperative pain after root canal retreatment:a preliminary placebocontrolled, triple-blind, randomized clinical trial. J Endod, 2017, 43(11):1765-1769. 汪莉, 钟素兰. 机用镍钛锉K3和ProTaper预备磨牙根管的临床应用比较. 四川医学, 2016, 27(11):1284-1287. SUN C, SUN J, TAN M, et al. Pain after root canal treatment with different instruments:a systematic review and meta-analysis. Oral Diseases, 2018, 24(6):908-919. LOPES H P, GAMBARRA-SOARES T, ELIAS C N, et al. Comparison of the mechanical properties of rotary instruments made of conventional nickel-titanium wire, M-wire, or nickel-titanium alloy in R-phase. J Endod, 2013, 39(4):516-520. 杨殷杰, 侯本祥, 侯晓玫. 自适应往复运动镍钛根管锉TFA的疲劳折断性能研究. 牙体牙髓牙周病学, 2016, 26(3):163-166. 吴幸晨, 王晓洁, 朱亚琴. 三种运动方式对TF单根镍钛器械在磨牙弯曲根管预备能力的比较研究. 牙体牙髓牙周病学, 2015, 25(8):477-482. CHELRY J. Effect of cyclic fatigue on static fracture loads in protaper nickel titanium rotary instruments. J Endod, 2005, 31(3):183-186. 邵彤菲, 侯晓玫, 侯本祥. 往复运动镍钛锉预备S型树脂根管成形能力的体外研究. 中华口腔医学杂志, 2014, 49(5):279-283. (2020-05-18收稿) (本文编校:张迪, 崔月婷) Methods A total of 55 patients with AIS were enrolled from the People's Hospital of Lujiang County from January 2017 to November 2019, and randomly divided into experimental group (n=27) and control group (n=28) according to random number table. All patients received routine treatment after admission to the hospital, and on this basis, control group was given alteplase thrombolysis, while experimental group was given intravenous drip of butyphthalide injection based on control group. We used generalized estimating equation (GEE) to compare the scores of the National Institutes of Health stroke scale (NIHSS) and modified Rankin scale (mRS). Results There was no statistically significant difference in NIHSS scores between two groups before treatment (P>0.05). The average NIHSS scores after treatment for 24 h and 7 d in experimental group were significantly lower than those in control group (P<0.05). The P-value of interaction item (group×time) was not statistically significant in NIHSS scores(P=0.189), but was statistically significant in mRS scores (P=0.033). Compared with control group, patients with AIS in experimental group also had lower scores of mRS after treatment for 24 h and 7 d, and the difference reached statistical significance for 7 d (P<0.05). The GEE models showed that patients with AIS in experimental group had an average NIHSS score of 3.071 (95%CI:-5.280, -0.862; P=0.006), and an average mRS score of 1.190 (95%CI:-1.953, -0.428; P=0.002), lower than those of control group. Conclusions Alteplase combined with butyphthalide have significant therapeutic efficacy in improving the symptoms of neurological deficits in patients with AIS. |
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