多模式MRI辅助静脉溶栓治疗急性前循环缺血性脑卒中疗效及对hs-CRP的影响

摘要

目的 观察多模式MRI辅助静脉溶栓治疗急性前循环缺血性脑卒中的临床效果及对超敏C反应蛋白(hs-CRP)的影响.方法 回顾性分析2013年11月-2015年10月在我院治疗的90例急性前循环缺血性脑卒中病人临床资料,其中47例行静脉溶栓治疗病人作为观察组,43例行常规抗血栓方法(非静脉溶栓)治疗病人作为对照组,均在多模式MRI辅助下治疗.观察两组的疗效、美国国立卫生院神经功能缺损评分(NIHSS)、Barthel指数评分、不良反应,观察两组hs-CRP水平变化.结果 观察组闭塞血管再通率为53.19％ (25/47),高于对照组的30.23％ (13/43),差异有统计学意义(P＜0.05);治疗7d后,观察组总有效率为85.11％,明显高于对照组的67.44％(P＜0.05).NIHSS评分观察组治疗后24h、3d、7d低于同期对照组(P＜0.05).Barthel指数评分:观察组治疗后24 h、3d、7d高于同期对照组(P＜0.05).两组总不良反应发生率差异无统计学意义(P＞0.05).两组治疗后血清hs-CRP水平较治疗前下降(P＜0.05),观察组治疗后血清hs-CRP低于对照组(P＜0.05).结论 多模式MRI辅助静脉溶栓治疗急性前循环缺血性脑卒病人能有效地改善神经功能缺损,提高日常生活活动能力,抑制炎症反应,治疗安全性较高.%Objective To observe the clinical efficacy of multi-mode magnetic resonance imaging (MRI) assisted intravenous thrombolysis in the treatment of anterior circulation acute ischemic stroke (AIS) and its effect on high-sensitivity C-reactive protein (hs-CRP).Methods Clinical data of ninety patients with anterior circulation AIS in our hospital from November 2013 to October 2015 were retrospectively analysis.Forty-seven patients underwent intravenous thrombolytic therapy as observation group,43 patients with conventional anti-thrombosis (non-venous thrombolysis) treatment as a control group,were treated with multi-mode MRI.The curative effect,National Institutes of Health Stroke Scale (NIHSS) scores,the Barthel index scores,and adverse reactions were observed.The change of serum hs-CRP level was observed.Results The recanalization rate of occluded vessel in observation group was higher than that in control group (53.19％ vs 30.23％,P ＜0.05).After treatment of 7 days,total effective rate in observation group was higher than that in control group (85.11％ vs 67.44％,P ＜0.05).There was significant difference in NIHSS scores between two groups at different time points.NIHSS scores in observation group were lower than that in control group after treatment of 24 hours,3 days,7 days,respectively (P ＜0.05).There was significant difference in Barthel index scores between two groups at different time points.Barthel index scores in observation group were higher than that in control group after treatment of 24 hours,3 days,7 days,respectively (P ＜0.05).There was no significant difference in the adverse reactions between two groups (P ＞0.05).The serum hs-CRP level decreased in two groups after treatment (P ＜0.05),which was lower in observation group than that in control group (P ＜0.05）.Conclusion Multi-mode MRI assisted intravenous thrombolysis can effectively improve nerve function defect,improve the ability of daily life activities,and inhibit inflammation in patients with anterior circulation AIS.