河北医科大学学报 ›› 2023, Vol. 44 ›› Issue (7): 786-791.doi: 10.3969/j.issn.1007-3205.2023.07.008

• • 上一篇    下一篇

DEVT与BT方案治疗急性大血管闭塞性脑梗死患者的效果及对预后的影响

  

  1. 1.河北中石油中心医院急诊科，河北 廊坊 065000；2.河北省人民医院神经内科，河北 石家庄 050057

  • 出版日期:2023-07-25 发布日期:2023-07-24
  • 作者简介:王琳（1987-），女，河北永清人，河北中石油中心医院主治医师，医学硕士，从事神经内科疾病诊治研究。
  • 基金资助:
    廊坊市科学技术研究与发展计划项目（2021013044）

Therapeutic effect of DEVT and BT on patients with acute large vessel occlusive cerebral infarction and their impact on prognosis

  1. 1.Department of Emergency, Hebei Petro China Central Hospital, Langfang 065000, China; 
    2.Department of Neurology,Hebei General Hospital, Shijiazhuang 050057, China

  • Online:2023-07-25 Published:2023-07-24

HTML

PDF (PC)

80

摘要： 目的 探讨直接血管内治疗（direct endovascular therapy，DEVT）与桥接治疗（bridging therapy，BT）方案对急性大血管闭塞性脑梗死患者的治疗效果及其对预后的影响。
方法 采用前瞻性随机研究方式选取急性大血管闭塞性脑梗死患者120例，按随机数字表法分为DEVT组和BT组，每组60例。DEVT组给予DEVT方案，BT组给予BT方案，观察2组治疗前后美国国立卫生研究院卒中量表（the National Institutes of Health Stroke Scale,NIHSS）评分、Barthel指数（Barthel index,BI）及改良Rankin评分（modified Rankin score，mRs）等，同时检测2组血清脑源性神经营养因子（brain-derived neurotrophic factor，BDNF）、神经特异性烯醇化酶（nerve specific enolase，NSE）、胰岛素样生长因子1（insulin-like growth factor-1，IGF-1）、超敏C反应蛋白（high-sensitivity C-reactive protein，hs-CRP）、肿瘤坏死因子α（tumor necrosis factor-α，TNF-α）、内皮素1（endothelin-1，ET-1）、一氧化氮（nitric oxide，NO）和降钙素基因相关肽（calcitonin gene-related peptide，CGRP）水平。
结果 2组患者mRS评分≤2分比例差异无统计学意义（P＞0.05）。治疗后1周,2组NIHSS评分、NSE明显低于治疗前，BDNF、IGF-1水平高于治疗前，BT组NIHSS评分、NSE明显低于DEVT组,BDNF、IGF-1明显高于DEVT组（P＜0.05）。治疗后24 h,2组 hs-CRP、TNF-α、ET-1水平低于治疗前，NO、CGRP水平高于治疗前，BT组ET-1水平低于DEVT组，NO和CGRP水平高于DEVT组（P＜0.05）。
结论 DEVT与BT方案治疗急性大血管闭塞性脑梗死患者均有显著的效果，BT方案更有助于患者神经功能的恢复，改善血管内皮功能。


关键词: 脑梗死, 直接血管内治疗, 桥接治疗

Abstract: Objective To investigate the therapeutic effects of direct endovascular therapy (DEVT) and bridging therapy (BT) on patients with acute large vessel occlusion cerebral infarction and their impact on prognosis. 
Methods A prospective randomized study was conducted to select 120 patients with acute large vessel occlusion cerebral infarction and divide them into DEVT group (n=60) and BT group (n=60) according to random number table method. DEVT group was given DEVT, and BT group was given BT. The scores of the National Institutes of Health Stroke Scale (NIHSS), Barthel index (BI), and modified Rankin score (mRs) were observed before and after treatment in both groups. In the meantime, serum brain derived neurotrophic factor (BDNF), nerve specific enolase (NSE), insulin-like growth factor-1 (IGF-1), high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), endothelin-1 (ET-1), nitric oxide (NO) and calcitonin gene-related peptide (CGRP) levels were detected in the two groups. 
Results There was no significant difference in the proportion of patients with mRS score ≤ 2 between two groups (P＞0.05). At one week after treatment, the NIHSS score and NSE in the two groups were significantly lower than those before treatment, while the levels of BDNF and IGF-1 were higher than those before treatment. The NIHSS score and NSE in the BT group were significantly lower than those in the DEVT group, while the BDNF and IGF-1 were significantly higher than those in the DEVT group (P＜0.05). At 24 h after treatment, the levels of hs-CRP, TNF-α, and ET-1 in the two groups were lower than those before treatment, while the levels of NO and CGRP were higher than those before treatment. The levels of ET-1 in the BT group were lower than those in the DEVT group, while the levels of NO and CGRP were higher than those in the DEVT group (P＜0.05). 
Conclusion Both DEVT and BT regimens have significant effects in the treatment of patients with acute large vessel occlusion cerebral infarction. BT regimens are more conducive to the recovery of neurological function and improvement of vascular endothelial function.  


Key words: brain infarction, direct endovascular therapy, bridging therapy

版权所有 © 《河北医科大学学报》编辑部
本系统由北京玛格泰克科技发展有限公司设计开发