Benefits and risks of intravenous thrombolysis in minor stroke and effects of combined urinary kallidinogenase on long-term prognosis of stroke

Q4 Medicine 中国医师杂志 Pub Date : 2019-12-20 DOI:10.3760/CMA.J.ISSN.1008-1372.2019.12.010

Qiang Zhou, P. Lin, L. Chi, Jing Lin, W. Chi

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Abstract

Objective To explore the clinical benefits and risks of intravenous thrombolysis combined with urinary kallidinogenase in the treatment of minor stroke. Methods The clinical data of 86 patients with minor stroke were retrospectively analyzed. Patients who received intravenous thrombolysis combined with urinary kallidinogenase were included in observation group (n=48), and those who received intravenous thrombolysis alone were included in control group (n=38). Before treatment and after 2 weeks of treatment, the imaging blood flow perfusion parameters [cerebral blood flow (CBF), mean transit time (MTT), time to peak (TTP)], and breath holding test indexes [cerebral vascular reactivity (CVR), breath holding index (BHI)] and serum biochemical indicators [vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF)] were compared between the two groups. The occurrence of adverse drug reactions during course of treatment and rehabilitation effects at 3 months after treatment [US National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS)] were analyzed in the two groups. Results After 2 weeks of treatment, the CBF, CVR, BHI and serum levels of VEGF and bFGF in the two groups were significantly higher than those before treatment, and the indexes in observation group were significantly higher than those in control group (P 0.05). At 3 months after treatment, there was no statistically significant difference in the effective rate of rehabilitation between the two groups (P>0.05), but the Mann-Whitney U rank sum test between-groups showed that the overall rehabilitation effects in observation group were significantly better than those in control group (P<0.05). Conclusions Intravenous thrombolysis has certain treatment effects in patients with minor stroke, and its safety is within the clinical controllable range. Combined with urinary kallidinogenase can obtain ideal long-term prognosis, and it is beneficial to the recovery of neurological function. Key words: Stroke; Thrombolytic therapy; Urinary kallidinogenase; Prognosis

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静脉溶栓治疗轻度脑卒中的益处和风险及联合尿碱二酚酶对脑卒中长期预后的影响

目的探讨静脉溶栓联合尿碱二酚酶治疗轻度脑卒中的临床获益及风险。方法回顾性分析86例轻度脑卒中患者的临床资料。观察组48例为静脉溶栓联合尿碱二酚原酶组，对照组38例为单独静脉溶栓组。比较两组患者治疗前和治疗2周后血流灌注成像参数[脑血流量(CBF)、平均传递时间(MTT)、到达峰值时间(TTP)]、屏气试验指标[脑血管反应性(CVR)、屏气指数(BHI)]和血清生化指标[血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)]。分析两组患者治疗过程中药物不良反应发生情况及治疗后3个月的康复效果[美国国立卫生研究院卒中量表(NIHSS)、改良Rankin量表(mRS)]。结果治疗2周后，两组患者CBF、CVR、BHI及血清VEGF、bFGF水平均显著高于同组治疗前，且观察组各指标均显著高于对照组(P < 0.05)。治疗后3个月，两组患者康复有效率比较，差异无统计学意义(P>0.05)，但组间Mann-Whitney U秩和检验显示，观察组患者整体康复效果显著优于对照组(P<0.05)。结论静脉溶栓对轻度脑卒中患者有一定的治疗效果，其安全性在临床可控范围内。联合尿碱二酚原酶治疗可获得理想的远期预后，并有利于神经功能的恢复。关键词:卒中;溶栓治疗;尿血管舒缓素;预后

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