依达拉奉联合rt-PA治疗对脑梗死患者的抗心磷脂抗体、内皮素-1和D-二聚体的影响

摘要

目的：观察依达拉奉联合重组组织型纤溶酶原激活剂（rt - PA）治疗对脑梗死的疗效及其对机体抗心磷脂抗体（ACA）、内皮素-1（ET -1）和 D -二聚体的影响。方法选择2011年1月至2013年12月住院急性脑梗死患者90例为对象，随机分为观察组和对照组，每组各45例。对照组予以 rt - PA 治疗，观察组在对照组的基础上予以依达拉奉治疗。观察两组的疗效，治疗前后美国国立卫生研究院卒中量表（NIHSS）和日常生活活动能力量表（ADL），ACA，ET-1和 D -二聚体水平的变化。结果观察组的总有效率为93.33％明显高于对照组的75.56％，差异有统计学意义（χ2=4.145，P <0.05）。治疗后两组 NIHSS 评分、ET -1和 D -二聚体水平较治疗前明显降低（ P <0.01），观察组的降低水平更为明显（ P <0.01）；而两组治疗后的 ADL 评分均较治疗前明显升高（ P <0.01），观察组的升高水平更为明显（ P <0.01）。结论依达拉奉联合 rt - PA 治疗急性脑梗死疗效确切，可能通过调节机体的脑血管舒缩功能、减轻脑水肿，保护脑神经细胞，从而达到改善神经功能的作用。%Objective To observe the curative effect of cerebral infarction in treatment of edaravone combined with recombinant tissue plasminogen activator(rt - PA)and its effect on the body′s anti - cardiolipin antibodies(ACA),endothelin - 1(ET - 1)and D - dimer. Meth-ods 90 patients with acute cerebral infarction,from January 2011 to December 2013 were included into this study. All these patients were ran-domly divided into observation group and control group,each group including 45 cases. The control group was treated with rt - PA,and the obser-vation group received edaravone in basis of the control group. The efficacy was observed,and the U. S. National Institutes of Health Stroke Scale (NIHSS),Activities of Daily Living Scale(ADL),ACA,changes in ET - 1 and D - dimer levels were also observed,recorded before and after treatment. Results The total effective rate was 93. 33% in observation group significantly higher than 75. 56% in control group,the difference was statistically significant(χ2 = 4. 145,P < 0. 05). After treatment,the NIHSS score,ET - 1 and D - dimer levels were significantly lower than those before treatment( P < 0. 01). The reducing levels of the observation group were more obvious( P < 0. 01);while,the ADL score af-ter treatment were significantly higher than those before treatment( P < 0. 01). The elevated levels of observation group were significantly more obvious( P < 0. 01). Conclusion The efficacy of acute cerebral infarction is obvious in treatment of edaravone combined rt - PA. It′s mecha-nism may regulate the body′s brain vasomotor function,relieve cerebral edema,protect brain cells,so as to improve the neurological function.