| 张昊,高立功,谭文刚,等.尤瑞克林在前循环急性大血管闭塞性卒中机械取栓术后的应用及对预后的影响[J].安徽医药,2023,27(2):409-413. |
| 尤瑞克林在前循环急性大血管闭塞性卒中机械取栓术后的应用及对预后的影响 |
| Application of urinary kallidinogenase in ALVOS patients after mechanical thrombectomy and its effects on prognosis |
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| DOI：10.3969/j.issn.1009-6469.2023.02.046 |
| 中文关键词: 脑梗死 卒中 颅内栓塞和血栓形成 血栓切除术 颈内动脉 尤瑞克林 机械取栓 预后 |
| 英文关键词: Brain infarction Stroke Intracranial embolism and thrombosis Thrombectomy Carotid artery, internal Uri-nary kallidinogenase Mechanical thrombectomy Prognosis |
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| 中文摘要: |
| 目的探究尤瑞克林在前循环急性大血管闭塞性卒中( ALVOS)病人机械取栓术后的应用及对预后的影响。方法选取 2018年 8月至 2020年 12月驻马店市中心医院入院就诊的 ALVOS病人 74例，采用随机数字表法分为对照组和观察组，各 37例。对照组采用机械取栓法治疗，观察组在对照组基础上加用尤瑞克林治疗 14 d，比较两组血液流变学、同型半胱氨酸(Hcy)、胱抑素( Cys)-C、基质金属蛋白酶 -9(MMP-9)、超敏 C反应蛋白(hs-CRP)、白细胞介素 6(IL-6)、肿瘤坏死因子 α(TNF-α)、美国国立卫生研究院卒中量表( NIHSS)评分、日常生活能力评定( Barthel指数)及 90 d病死率。结果治疗前，两组病人血液流变学指标［血浆黏度( PV)、全血低切黏度( LWBV)、全血高切黏度( HWBV)、纤维蛋白原( FIB)］、 Hcy、Cys-C、MMP-9、hs-CRP、 IL-6、TNF-α水平比较，差异无统计学意义( P>0.05)；治疗后，两组 PV(1.37±0.41，1.74±0.52)mPs/s、LWBV(3.68±1.05，4.33± 1.17)mPs/s、HWBV(6.35±1.38，8.75±1.59)mPs/s、FIB(249.55±21.69，289.62±26.48)g/L、Hcy(11.36±2.68，17.59±3.24)μmol/L、 Cys-C(0.81±0.21，1.26±0.29)mg/L、MMP-9(246.33±22.98，282.57±25.54)μg/L、hs-CRP(10.21±2.25，14.47±2.68)mmol/L、IL-6(8.45±2.78，13.61±3.37)ng/L、TNF-α(7.54±2.30，11.73±3.18)ng/L较治疗前均显著降低( P<0.05)，且观察组上述指标改善程度明显优于对照组( P<0.05)。治疗前，两组病人 NHISS评分、 Barthel指数比较，差异无统计学意义(P>0.05)；治疗后 24 h、治疗后 7 d、治疗后 90 d，两组 NHISS评分 24 h(10.41±2.26，11.35±2.51)分、 7d(5.29±1.34，7.92±1.58)分和 90 d(1.62±0.52，1.95±0.58)分较治疗前明显改善( P<0.05)，且观察组治疗后 7d、治疗后 90 d NHISS评分低于对照组( P<0.05)；治疗后、治疗后 90 d，两组 Bar-thel指数( 73.55±15.24，59.64±12.67)分和 90 d(78.63±14.47，62.30±13.15)分较治疗前明显改善( P<0.05)且观察组 Barthel指数高于对照组( P<0.05)。治疗后 90 d内两组均未有死亡病例。结论 ALVOS病人机械取栓术后应用尤克林，可明显改善病瑞，人神经功能及短期预后，可能与尤瑞克林改善缺血脑组织血流量、抗炎作用有关。 |
| 英文摘要: |
| Objective To explore the application and prognostic effect of urinary kallidinogenase in patients with acute large vascu-lar occlusion stroke (ALVOS) of the anterior circulation after mechanical thrombectomy.Methods A total of 74 patients with ALVOSadmitted to the Zhumadian Central Hospital from August 2018 to December 2020 were selected and divided into a control group and anobservation group using the random number table method, with 37 cases each. The control group was treated with mechanical thrombec-tomy, and the observation group was treated with urinary kallidinogenaseon on the basis of the control group. The hemorheology, homo‐cysteine (Hcy), cystatin C (Cys-C), matrix metalloproteinase-9 (MMP-9), high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), National Institutes of Health Stroke Scale (NIHSS) score, assessment of daily living ability (Barthel index) and 90-d mortality rate were compared between the two groups.Results Before treatment, there were no statistically significant differences in the levels of hemorheology indices [plasma viscosity (PV), low-cut whole blood viscosity (LWBV), high-cut whole blood viscosity (HWBV), fibrinogen (FIB)], Hcy, Cys-C, MMP-9, hs-CRP, IL-6 and TNF-α when compared between the two groups of patients (P>0.05). After treatment, PV (1.37±0.41, 1.74±0.52) mPs/s, LWBV (3.68±1.05, 4.33±1.17) mPs/s, HWBV (6.35±1.38, 8.75±1.59)mPs/s, FIB (249.55±21.69, 289.62±26.48) g/L, Hcy (11.36±2.68, 17.59±3.24) μmol/L, Cys-C (0.81±0.21, 1.26±0.29) mg/L, MMP-9 (246.33±22.98, 282.57±25.54) μg/L, hs-CRP (10.21±2.25, 14.47±2.68) mmol/L, IL-6 (8.45±2.78, 13.61±3.37) ng/L and TNF-α (7.54± 2.30, 11.73±3.18) ng/L in both groups were significantly lower than before treatment (P<0.05), and the improvement of the above indi-ces in the observation group was significantly better than that in the control group (P<0.05). Before treatment, there was no significant difference in the NIHSS score or Barthel index between the two groups (P>0.05). The NIHSS scores [24 h (10.41±2.26 vs. 11.35± 2.51) points, 7 d (5.29±1.34 vs. 7.92±1.58) points, 90 d (1.62±0.52 vs. 1.95±0.58) points] in the two groups were significantly improved compared with the pretreatment scores (P<0.05), and the NIHSS score was lower in the observation group at 7 d and 90 d after treat-ment than in the control group (P<0.05). After treatment and 90 d after treatment, the Barthel index [(73.55±15.24 vs. 59.64±12.67) points, 90 d (78.63±14.47 vs. 62.30±13.15) points] scores in both groups were significantly improved compared with those before treat-ment (P<0.05), and the Barthel index in the observation group was higher than that in the control group (P<0.05). There were no deaths in either group within 90 d after treatment.Conclusion The application of urinary kallidinogenase in ALVOS patients after mechani-cal thrombectomy can significantly improve patients' neurological function and short-term prognosis, which may be related to the im-provement of blood flow to ischemic brain tissue and the anti-inflammatory effect of urinary kallidinogenase. |
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