动脉内溶栓联合高压氧对重症缺血性脑卒中患者血清 CGRP 、sICAM—1 水平的影响

摘要

目的:探讨经动脉内溶栓联合高压氧对重症缺血性脑卒中患者血清可溶性细胞间黏附分子—1 (sICAM—1 ) 、降钙素基因相关肽(CGRP)水平的影响.方法:选择我院重症缺血性脑卒中患者96例,随机均分为溶栓治疗组和联合治疗组(动脉内溶栓+高压氧治疗) .采用神经功能缺损量表(NIHSS)评估神经功能恢复情况,采用改良Rankin量表(mRS)评估临床症状恢复情况,治疗两周后,比较两组临床疗效, NIHSS等的变化.结果:治疗后,与溶栓治疗组比较,联合治疗组总有效率显著提高(77. 08% 比93. 75%, P＝0. 021) ; NIHSS [ (8. 10 ± 3.45)分比(5. 36 ± 2.11)分]及mRS [ (2. 58 ± 0.80)分比(1. 81 ± 0.76)分]评分显著降低( P均＝0. 001) ;血清sI—CAM—1 [(237. 31 ± 18.04) ng／ml比(220.25 ± 16. 40) ng／ml]水平显著降低,血清CGRP [(27.02 ± 6.06) pg／ml比(35.24 ± 6.13) pg／ml]水平显著升高( P均＝0.001) ;两组间两周血管再通情况比较差异无统计学意义( P＞0.05).结论:联合动脉内溶栓与高压氧治疗重症缺血性脑卒中效果显著,可缓解患者临床症状,恢复认知功能,提高血管再通率.%Objective :To explore influence of intra—arterial thrombolysis combined hyperbaric oxygen on serum levels of soluble intercellular adhesion molecule—1 (sICAM—1) and calcitonin gene related peptide (CGRP) in patients with severe ischemic stroke .Methods : A total of 96 patients with severe ischemic stroke in our hospital were randomly and equally divided into thrombolysis group and combined treatment group (received intra—arterial thrombolysis +hyperbaric oxygen therapy ).United States National Institutes of Health Stroke score (NIHSS) was used to assess neurological function recovery , and modified Rankin rating score (mRS) was used to assess recovery of clinical symptoms.After two—week treatment ,clinical therapeutic effect etc .were compared between two groups .Results :Compared with thrombolysis group after treatment ,there was significant rise in total effective rate (77.08% vs. 93. 75%, P＝0.021) ;significant reductions in scores of NIHSS [ (8.10 ± 3.45) scores vs .(5.36 ± 2.11) scores] and mRS [ (2.58 ± 0. 80) scores vs .(1.81 ± 0.76) scores] ;significant reduction in serum sICAM—1 level [ (237.31 ± 18. 04) ng／ml vs.(220.25 ± 16.40) ng／ml] ,and significant rise in serum CGRP level [ (27.02 ± 6.06) pg／ml vs. (35.24 ± 6.13) pg／ml] in combined treatment group , P＝0.001 all.There was no significant difference in revascu—larization within two weeks between two groups , P＝0.551. Conclusion : Intra—arterial thrombolysis combined hy—perbaric oxygen possesses significant therapeutic effect on patients with severe ischemic stroke .It can relieve clinical symptoms ,recover cognitive function ,improve revascularization rate in these patients .