降纤酶与阿加曲班对急性缺血性脑卒中患者脑血流动力学凝血/纤溶系统及血清GFAP OPN的影响Effects of defibrase combined with argatroban on cerebral hemodynamics,coagulation/fibrinolysis system and serum GFAP and OPN expression in patients with acute ischemic stroke
于洋;项广宇;李涛;钱哲;
摘要(Abstract):
目的分析降纤酶结合阿加曲班对急性缺血性脑卒中(AIS)患者脑血流动力学、凝血/纤溶系统及血清神经胶质纤维酸性蛋白(GFAP)、骨桥蛋白(OPN)表达的影响。方法选取2018-03—2020-05许昌市中心医院AIS患者124例,以随机数字表分为研究组(n=62)、对照组(n=62)。在常规治疗基础上,对照组予以降纤酶,研究组予以降纤酶及阿加曲班,均治疗1周。对比分析2组疗效与治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、日常生活活动能力量表(BI)评分、大脑中动脉血流动力学[收缩期峰值血流速度(V_(max))、阻力指数(PI)、平均血流速度(V_(mean))]、凝血/纤溶系统[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤溶酶原活性(PLG)、纤维蛋白原(FIB)]、血清炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)]、GFAP、OPN水平。结果研究组治疗1周后总有效率95.16%,高于对照组的79.03%(P<0.05);2组治疗1周后NIHSS评分与PI水平较治疗前降低,且研究组低于对照组,BI评分与V_(max)、V_(mean)水平均较治疗前提高,且研究组高于对照组(P<0.05);2组治疗1周后PT、APTT、FIB与血清IL-6、TNF-α、hs-CRP、GFAP、OPN水平较治疗前降低,且研究组低于对照组,PLG水平较治疗前提高,且研究组高于对照组(P<0.05)。结论降纤酶联合阿加曲班治疗AIS患者可改善脑血流动力学与凝血/纤溶系统,减轻炎症反应,下调GFAP、OPN表达,降低神经功能缺损程度,提升日常生活能力。
关键词(KeyWords): 急性缺血性脑卒中;降纤酶;阿加曲班;脑血流动力学;凝血/纤溶系统;神经胶质纤维酸性蛋白;骨桥蛋白
基金项目(Foundation): 许昌市重大科技专项(转型升级创新专项)(编号:20180113031)
作者(Authors): 于洋;项广宇;李涛;钱哲;
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