Efficacy of intravenous thrombolysis combined with mechanical stent interventional thrombectomy on acute ischemic stroke.

IF 2 4区 医学 Q4 BIOCHEMISTRY & MOLECULAR BIOLOGY
Jun Huang, Ming Zhang, Qingbin Nie, Xinye Zhang, Xin He, Yufeng Yang, Gengsheng Mao
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引用次数: 0

Abstract

Background: To investigate the efficacy and safety of intravenous thrombolysis combined with mechanical stent interventional thrombectomy in the treatment of acute ischemic stroke.

Methods: A retrospective analysis was carried out for clinical data of 118 patients with acute ischemic stroke. The patients enrolled were divided into control group (recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis) and thrombectomy group (mechanical stent interventional thrombectomy based on rt-PA intravenous thrombolysis). The vascular recanalization rate and clinical efficacy after treatment were compared between the two groups. National Institutes of Health Stroke Scale (NIHSS) was used to identify the degree of neurological impairment in all patients before and after treatment, and Barthel Index was used to assess their activity of daily living. Moreover, the changes in the levels of T-lymphocyte subpopulation in peripheral blood and immuno-inflammatory factors before and after treatment were compared, and prognosis of patients and incidence of adverse reactions were recorded.

Results: The response rate inthrombectomy group (93.2%) was significantly better than that in control group (76.3%). The NIHSS sore and modified Rankin scale (mRS) score after treatment were significantly lower than those before treatment, while the Barthel Index after treatment was distinctly higher than that before treatment. The NIHSS score and mRS score in thrombectomy group obviously declined compared with those in control group at 1 month after treatment. The Barthel Index in thrombectomy group was obviously higher than that in control group at 1 month and 2 months after treatment. Levels of cluster of differentiation 3 (CD3)+, CD3+CD4+, CD4+/CD8+ and natural killer (NK) cells in peripheral blood at 6 months after treatment evidently rose compared with those before treatment, while level of CD3+CD8+ evidently declined compared with that before treatment. In thrombectomy group, levels of CD3+, CD3+CD4+, CD4+/CD8+ and NK cells were markedly higher than those in control group, while the level of CD3+CD8+ was markedly lower than that in control group. Besides, in thrombectomy group, levels of serum osteopontin (OPN), malondialdehyde (MDA) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were evidently lower than those in control group at 1 month after treatment, while the level of serum superoxide dismutase (SOD) was evidently higher than that in control group. Compared with that in control group, the acute vascular reocclusion rate in thrombectomy group was significantly decreased at 3 months after treatment (10.2% vs. 22.0%).

Conclusions: Intravenous thrombolysis combined with mechanical stent interventional thrombectomy can effectively promote the vascular recanalization, improve the neurological function and activity of daily living of patients, reinforce the immunological function, inhibit the oxidative stress response and improve the prognosis of patients.

Abstract Image

静脉溶栓联合机械支架介入取栓治疗急性缺血性脑卒中疗效观察。
背景:探讨静脉溶栓联合机械支架介入取栓治疗急性缺血性脑卒中的疗效和安全性。方法:对118例急性缺血性脑卒中患者的临床资料进行回顾性分析。纳入的患者分为对照组(重组组织纤溶酶原激活剂(rt-PA)静脉溶栓)和取栓组(rt-PA静脉溶栓基础上的机械支架介入取栓)。比较两组治疗后血管再通率及临床疗效。采用美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale, NIHSS)评估治疗前后患者神经功能损害程度,采用Barthel指数评估患者日常生活活动能力。比较治疗前后外周血t淋巴细胞亚群及免疫炎症因子水平的变化,记录患者预后及不良反应发生情况。结果:取栓组有效率(93.2%)明显优于对照组(76.3%)。治疗后NIHSS疮和改良Rankin量表(mRS)评分均显著低于治疗前,Barthel指数显著高于治疗前。治疗后1个月,取栓组NIHSS评分和mRS评分较对照组明显下降。取栓组在治疗后1个月和2个月的Barthel指数明显高于对照组。治疗后6个月外周血CD3+、CD3+CD4+、CD4+/CD8+、NK细胞水平较治疗前明显升高,CD3+CD8+水平较治疗前明显下降。取栓组CD3+、CD3+CD4+、CD4+/CD8+、NK细胞水平均明显高于对照组,CD3+CD8+水平明显低于对照组。此外,取栓组治疗后1个月血清骨桥蛋白(OPN)、丙二醛(MDA)、n端前b型利钠肽(NT-proBNP)水平明显低于对照组,血清超氧化物歧化酶(SOD)水平明显高于对照组。与对照组相比,取栓组治疗后3个月急性血管再闭塞率显著降低(10.2% vs 22.0%)。结论:静脉溶栓联合机械支架介入取栓可有效促进血管再通,改善患者神经功能和日常生活活动能力,增强免疫功能,抑制氧化应激反应,改善患者预后。
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来源期刊
Journal of Medical Biochemistry
Journal of Medical Biochemistry BIOCHEMISTRY & MOLECULAR BIOLOGY-
CiteScore
3.00
自引率
12.00%
发文量
60
审稿时长
>12 weeks
期刊介绍: The JOURNAL OF MEDICAL BIOCHEMISTRY (J MED BIOCHEM) is the official journal of the Society of Medical Biochemists of Serbia with international peer-review. Papers are independently reviewed by at least two reviewers selected by the Editors as Blind Peer Reviews. The Journal of Medical Biochemistry is published quarterly. The Journal publishes original scientific and specialized articles on all aspects of clinical and medical biochemistry, molecular medicine, clinical hematology and coagulation, clinical immunology and autoimmunity, clinical microbiology, virology, clinical genomics and molecular biology, genetic epidemiology, drug measurement, evaluation of diagnostic markers, new reagents and laboratory equipment, reference materials and methods, reference values, laboratory organization, automation, quality control, clinical metrology, all related scientific disciplines where chemistry, biochemistry, molecular biology and immunochemistry deal with the study of normal and pathologic processes in human beings.
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