摘要
目的分析不同时机行Solitarie支架动脉取栓术治疗大动脉闭塞性急性脑梗死的效果。方法抽取2018年6月至2019年7月南阳市中心医院收治的大动脉闭塞性急性脑梗死患者86例,按照发病至就医时间分为两组,发病至就医时间<4.5 h者纳入观察组44例,发病至就医时间≥4.5 h者42例纳入对照组。两组患者均接受Solitarie支架动脉取栓术治疗。比较两组患者神经功能缺损、血清脑源性神经营养因子(BDNF)、血清神经营养因子(NTF)、血管内皮生长因子(VEGF)、转化生长因子-β1(TGF-β1)水平及并发症。结果术前对照组患者美国国立卫生研究院卒中量表(NIHSS)评分为(7.21±1.62)分,低于观察组的(7.28±1.65)分,差异未见统计学意义(P>0.05);术后观察组患者NIHSS评分为(4.41±1.71)分,低于对照组(6.07±1.73)分,差异有统计学意义(P<0.05)。术前两组患者BDNF、NTF水平比较,差异未见统计学意义(P>0.05),术后增加;术后观察组患者BDNF水平为(13.71±2.67)ng/ml、NTF水平为(6.43±0.26)ng/ml,高于对照组的(11.98±2.63)ng/ml、(4.68±0.21)ng/ml(P<0.05)。术前两组患者VEGF、TGF-β1水平比较,差异未见统计学意义(P>0.05),治疗后VEGF、TGF-β1降低水平;其中观察组患者VEGF水平为(21.74±6.82)pg/ml,低于对照组的(35.97±6.84)pg/ml(P<0.05)。观察组患者并发症发生率、血管再开通率低于对照组(P<0.05)。结论发病至就医时间<4.5 h进行Solitarie支架动脉取栓术可保护大动脉闭塞性急性脑梗死神经功能,减少血栓形成,减少并发症,有利于提升治疗效果。
Objective To investigate the effects of thrombectomy with Solitaire stent of different operation times in patients with aortic occlusive acute cerebral infarction.Methods A total of 86 patients with aortic occlusive acute cerebral infarction in the Nanyang Central Hospital from June 2018 to July 2019 were enrolled,and divided into two groups according to the time interval between onset and treatment.Among them,44 cases were included in the observation group when the time from onset to medical treatment was less than 4.5 h,and 42 cases when the time from onset to medical treatment was more than 4.5 h.Both groups received thrombectomy with Solitarie stent.Neurological deficits,serum brain-derived neurotrophic factor(BDNF),serum neurotrophic factor(NTF),vascular endothelial growth factor(VEGF),TGF-β1 levels and complication rates were compared between the two groups.Results Before operation the National Institutes of Health Stroke Scale(NIHSS)score of the control group was(7.21±1.62),which was lower than(7.28±1.65)of the observation group and the difference was not statistically significant(P>0.05);after operation,the NIHSS score of the observation group was(4.41±1.71),which was lower than(6.07±1.73)of the control group,the difference was statistically significant(P<0.05);there was no significant difference in the levels of BDNF and NTF between the two groups before operation(P>0.05);after operation,BDNF level was(13.71±2.67)ng/ml,and NTF levels was(6.43±0.26)ng/ml in the observation group,which were higher than(11.98±2.63)ng/ml and NTF(4.68±0.21)ng/ml in the control group(P<0.05);there was no significant difference in the levels of VEGF and TGF-β1 between the two groups before operation(P>0.05);after treatment,the levels of VEGF in the observation group were(21.74±6.82)pg/ml,which was lower than that in the control group(P<0.05).The complication rate and recanalization rate of the observation group were lower than those of the control group(P<0.05).Conclusions Thrombectomy within 4.5 hours of onset can protect the nerve function,reduce thrombosis and complication rate for patients with aortic occlusive acute cerebral infarction.
作者
张黎雪
王洁
王彦平
Zhang Lixue;Wang Jie;Wang Yanping(Department of Neurology,Nanyang Central Hospital,Nanyang 473000,China)
出处
《中国实用医刊》
2021年第6期90-93,共4页
Chinese Journal of Practical Medicine
关键词
脑动脉取栓术
大动脉闭塞性
急性脑梗死
神经功能
并发症
因子
Cerebral artery thrombectomy
Occlusion of great arteries
Acute cerebral infarction
Neurological function
Complications
Factors
