本文選題：心源性腦梗死 + 阿替普酶��； 參考：《中國老年學雜志》2017年24期

【摘要】：目的探討阿替普酶(rt-PA)溶栓治療心源性腦梗死后血清腦鈉肽(BNP)、肝細胞生長因子(HGF)和S-100β蛋白的表達水平及臨床意義。方法心源性腦梗死患者120例,按照美國國立衛(wèi)生研究院卒中量表(NIHSS)評分分為輕型、中型和重型腦梗死;按照腦梗死體積分為小、中和大梗死灶組。比較不同程度腦梗死患者和不同梗死體積患者血清BNP、HGF和S-100β蛋白水平的差異。隨機將患者分為rt-PA靜脈溶栓治療組(60例)和非溶栓治療對照組(60例),治療前及治療1、3、7 d時統(tǒng)計兩組NIHSS評分、治療效果,檢測不同治療時間點血清BNP、HGF和S-100β蛋白水平的變化。結(jié)果隨著腦梗死程度加重和腦梗死體積的增加,血清BNP、HGF和S-100β蛋白水平均逐漸升高(P0.05)。治療后1、3、7 d,治療組NIHSS評分均顯著低于對照組(P0.05);治療組總有效率顯著高于對照組(P0.05);隨著治療時間的延長,治療組血清BNP、HGF和S-100β蛋白水平均顯著低于治療前(P0.05);且對照組只在第7天檢測時顯著低于治療前(P0.05);同一檢測時間點,治療組均顯著低于對照組(P0.05)。結(jié)論阿替普酶溶栓治療心源性腦梗死具有較好的治療效果,血清BNP、HGF和S-100β蛋白水平與心源性腦梗死病情嚴重程度和梗死體積呈正相關(guān)關(guān)系,對于心源性腦梗死的臨床診斷、病情監(jiān)測和療效評價具有重要的意義。
[Abstract]:Objective to investigate the expression levels of BNP, HGFand S-100 尾 protein and S-100 尾 protein in patients with cardiogenic cerebral infarction after thrombolytic therapy. Methods 120 patients with cardiogenic cerebral infarction were divided into mild moderate and severe cerebral infarction according to the National Institutes of Health Stroke scale (NIHSS) and small moderate and large infarct according to the volume of cerebral infarction. The serum BNPHGF and S-100 尾 protein levels were compared between patients with different degrees of cerebral infarction and patients with different infarct volumes. The patients were randomly divided into rt-PA intravenous thrombolytic therapy group (n = 60) and non-thrombolytic therapy group (n = 60). The NIHSS scores of the two groups were calculated before treatment and 1 day after treatment. The effect of treatment and the changes of serum BNP-HGF and S-100 尾 protein were detected at different time points. Results with the aggravation of cerebral infarction and the increase of cerebral infarction volume, the levels of serum BNPP HGF and S-100 尾 protein increased gradually (P 0.05). The NIHSS scores in the treatment group were significantly lower than those in the control group at 1: 3 and 7 days after treatment, and the total effective rate in the treatment group was significantly higher than that in the control group, and with the prolongation of the treatment time, the total effective rate of the treatment group was significantly higher than that of the control group. The levels of serum BNPP HGF and S-100 尾 protein in the treatment group were significantly lower than those in the control group before treatment, and in the control group were only significantly lower than that in the control group on the 7th day, and at the same time point, the levels of BNPHGF and S-100 尾 protein in the treatment group were significantly lower than those in the control group. Conclusion Atiplase thrombolytic therapy is effective in the treatment of cardiogenic cerebral infarction. The levels of serum BNPP HGF and S-100 尾 protein are positively correlated with the severity of cardiogenic cerebral infarction and the volume of infarction, and the clinical diagnosis of cardiogenic cerebral infarction. It is of great significance to monitor the disease and evaluate the curative effect.
【作者單位】： 武漢市武昌醫(yī)院神經(jīng)內(nèi)科;
【基金】：湖北省衛(wèi)計委資助項目(WJ2015MB250) 武漢市衛(wèi)計委資助項目(WX15C17)
【分類號】：R743.33

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