【摘要】：目的探討阿替普酶溶栓療法對(duì)老年急性腦梗死患者神經(jīng)功能、顱內(nèi)血流動(dòng)力學(xué)、神經(jīng)元特異性烯醇化酶(NSE)、中樞神經(jīng)特異性蛋白(S-100β)含量及生活質(zhì)量的影響。方法 120例老年急性腦梗死患者分為觀察組(靜脈溶栓治療,n=60)和對(duì)照組(非靜脈溶栓治療,n=60),對(duì)照組給予常規(guī)治療,觀察組采用阿替普酶靜脈溶栓治療。比較兩組治療前后不同時(shí)間神經(jīng)功能缺損程度、大腦中動(dòng)脈(MCA)血流動(dòng)力學(xué)變化、NSE和S-100β蛋白含量、殘障水平及生活質(zhì)量。結(jié)果治療后3~28 d兩組美國國立衛(wèi)生研究院卒中量表(NIHSS)評(píng)分均呈逐漸降低趨勢(shì),且治療后7~28 d觀察組NIHSS評(píng)分明顯低于對(duì)照組(P0.05或P0.01);治療后1 h兩組MCA收縮期峰值流速(Vp)、舒張末期流速(Vd)和平均流速(Vm)均明顯增加,且觀察組明顯大于對(duì)照組(P0.05或P0.01);治療后3~28 d兩組NSE及S-100β蛋白含量均呈先升高后降低趨勢(shì),治療后14~28 d觀察組均明顯低于對(duì)照組(P0.01);經(jīng)過3個(gè)月的治療,觀察組腦卒中專門化生存質(zhì)量量表(SS-QOL)評(píng)分與對(duì)照組比較明顯升高改良RANKIN量表(mRS)評(píng)分與對(duì)照組比較明顯降低(P0.05)。結(jié)論阿替普酶靜脈溶栓可以明顯增加老年急性腦梗死患者腦血流速度,降低NSE及S-100β蛋白含量,有效緩解患者神經(jīng)功能缺損程度,進(jìn)一步降低患者殘障水平,對(duì)改善患者生活質(zhì)量具有積極作用。
[Abstract]:Objective to investigate the effects of atropase thrombolytic therapy on neurological function, intracranial hemodynamics, neuron-specific enolase (NSE), central nervous system specific protein (S-100 尾) and quality of life (QOL) in elderly patients with acute cerebral infarction. Methods 120 elderly patients with acute cerebral infarction were divided into observation group (intravenous thrombolytic therapy, nong60) and control group (non-venous thrombolytic therapy, nong60). The control group was treated with routine therapy, and the observation group was treated with intravenous thrombolytic therapy with atropine. The changes of (MCA) hemodynamics, the contents of NSE and S-100 尾 protein, the level of disability and the quality of life were compared between the two groups before and after treatment. Results the (NIHSS) score of the stroke scale of the National Institutes of Health in the two groups decreased gradually at 3 to 28 days after treatment, and the NIHSS score of the observation group was significantly lower than that of the control group on the 7th day after treatment (P0.05 or P0.01). At 1 hour after treatment, the peak systolic velocity of MCA, (Vp), end-diastolic velocity (Vd) and mean flow velocity (Vm) were significantly increased in both groups, and the value of (Vd) in the observation group was significantly higher than that in the control group (P0.05 or P0.01). The contents of NSE and S-100 尾 protein in the two groups increased first and then decreased on the 3rd and 28th day after treatment, and were significantly lower in the observation group than in the control group at 1428 days after treatment (P0.01). After 3 months of treatment, the scores of SS-QOL in the observation group were significantly higher than those in the control group, and the (mRS) score of the modified RANKIN scale was significantly lower than that of the control group (P0.05). Conclusion intravenous thrombolysis with atropine can significantly increase the cerebral blood flow velocity, decrease the contents of NSE and S-100 尾 protein, alleviate the degree of neurological impairment and further decrease the disability level of the elderly patients with acute cerebral infarction. It plays a positive role in improving the quality of life of patients.
【作者單位】： 白銀市第一人民醫(yī)院神經(jīng)內(nèi)科;甘肅省人民醫(yī)院腦血管病中心;
【分類號(hào)】：R743.33

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