阿替普酶联合银杏二萜内酯葡胺治疗磁共振 DWI-FLAIR失配急性缺血性脑卒中的临床观察

Clinical observation of alteplase and ginkgo diterpene lactone meglumine on acute ischemic stroke with MRI DWI /FLAIR mismatch

摘要:

目的 观察阿替普酶联合银杏二萜内酯葡胺（GDLM）对磁共振弥散加权成像（MRI DWI）与液体衰减反 转恢复成像（FLAIR）失配急性缺血性脑卒中（AIS）的疗效。方法 94 例MRI-DWI/FLAIR失配AIS患者随机接受阿替 普酶（对照组）或阿替普酶联合GDLM（观察组）治疗 2 周，比较两组疗效、不良反应、血清炎症因子（IL-6、IL-8、IL-1β、hsCRP）水平、血液流变学指标。结果 观察组疗效明显优于对照组（P<0.05），但不良反应差异无统计学意义（P>0.05）。 两组治疗后IL-6、IL-8、hs-CRP和IL-1β水平及血液流变学指标均明显低于治疗前，其中观察组更显著（P<0.01 或 0.05）。 结论 阿替普酶联合GDLM治疗MRI DWI-FLAIR失配AIS疗效优于单用阿替普酶治疗者，显著降低炎症因子水平和改 善血液流变学指标。

Abstract:

Objective To observe the efficacy of combined alteplase and ginkgo diterpene lactone meglumine (GDLM) in acute ischemic stroke (AIS) with magnetic resonance imaging diffusion weighted imaging/fluid attenuated inversion recovery (MRI DWI/FLAIR) mismatch. Methods Ninety-four AIS patients with MRI DWI/FLAIR mismatch were randomly treated with alteplase (control group) or alteplase and GDLM (observation group) for 2 weeks. Clinical efficacy, serum inflammatory factors (IL-6, IL-8, IL-1β, and hs-CRP), hemorheological indicators, and adverse reactions were compared between 2 groups. Results The curative effect was better in observation group than in control group (P<0.05), but no significant difference of adverse reactions was noted between 2 groups (P>0.05). Levels of IL-6, IL-8, hs-CRP and IL-1β and hemorheological parameters were lower after therapy in both groups, especially in observation group (P<0.01 or 0.05). Conclusion Clinical efficacy of combined alteplase and GDLM is superior to that of alteplase in AIS patients with MRI DWI/FLAIR mismatched by reducing inflammatory cytokines and improving hemorheological indicators.