Influence of cerebroside carnosine combined with intravenous thrombolysis with recombinant human tissue plasminogen activator on serum high-sensitivity C reactive protein and insulin-like growth factor-1 levels in patients with acute ischemic stroke
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摘要:目的 探讨脑苷肌肽联合重组人组织型纤溶酶原激活物(rt-PA)静脉溶栓对急性缺血性脑卒中患者血清超敏C反应蛋白(hs-CRP)、胰岛素样生长因子-1(IGF-1)水平的影响。方法 选取120例急性缺血性脑卒中患者, 随机分为2组各60例。对照组采取rt-PA静脉溶栓治疗，研究组在对照组基础上加用脑苷肌肽注射液。比较2组治疗前及疗程结束后的日常生活能力(ADL)及美国国立卫生研究院卒中量表(NIHSS)评分、临床疗效、血清hs-CRP、IGF-1水平以及不良反应发生率。结果 研究组总有效率91.67%, 显著高于对照组71.67%(P < 0.05)。2组疗程结束后NIHSS较治疗前显著降低, ADL较治疗前显著增高，且研究组显著优于对照组(P < 0.05)。疗程结束后, 2组IGF-1水平显著高于治疗前, hs-CRP显著低于治疗前，且研究组显著优于对照组(P < 0.05)。研究组不良反应发生率15.00%, 与对照组11.67%比较无显著差异(P>0.05)。结论 应用rt-PA静脉溶栓联合脑苷肌肽注射液治疗急性缺血性脑卒中安全有效，可调节血清hs-CRP、IGF-1水平，改善神经功能及提高日常生活能力，且不会增加不良反应发生率。
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关键词:
- 脑苷肌肽 /
- 重组人组织型纤溶酶原激活物 /
- 静脉溶栓 /
- 急性缺血性脑卒中 /
- 超敏C反应蛋白 /
- 胰岛素样生长因子-1
Abstract:Objective To investigate the influence of cerebroside carnosine combined with intravenous thrombolysis with recombinant human tissue plasminogen activator (rt-PA) on serum high-sensitivity C reactive protein (hs-CRP) and insulin-like growth factor-1 (IGF-1) levels in patients with acute ischemic stroke.Methods A total of 120 patients with acute ischemic stroke were selected and randomly divided into two groups, with 60 cases in each group. The control group was treated with rt-PA intravenous thrombolysis, while the study group was treated with cerebroside carnosine injection on the basis of the control group. The scores of Activities of Daily Living (ADL) and National Institutes of Health Stroke Scale (NIHSS), clinical efficacy, serum hs-CRP and IGF-1 levels, and the incidence rate of adverse reactions were compared between the two groups before and after treatment.Results The total effective rate was 91.67% in the study group, which was significantly higher than 71.67% in the control group (P < 0.05). After treatment, the NIHSS score was significantly lower and ADL was significantly higher in both groups, and the scores in study group were significantly better than the control group (P < 0.05). After treatment, the levels of IGF-1 and hs-CRP in both groups were significantly higher than those before treatment, and the level of hs-CRP in the study group was significantly higher than that in the control group (P < 0.05). The incidence rate of adverse reactions in the study group was 15.00%, which showed no significant difference when compared to 11.67% in the control group (P>0.05).Conclusion Application of rt-PA intravenous thrombolysis combined with cerebroside carnosine injection is safe and effective in the treatment of acute ischemic stroke, which can regulate the levels of serum hs-CRP and IGF-1, improve nerve function and daily living ability, and does not increase the incidence rate of adverse reactions. -
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表 1 2组临床疗效比较[n(%)]
组别 n 显效 有效 无效 总有效 研究组 60 29(48.33) 26(43.33) 5(8.33) 55(91.67)* 对照组 60 21(35.00) 22(36.67) 17(28.33) 43(71.67) 与对照组比较, *P < 0.05。 
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表 2 2组NIHSS及ADL评分比较(x±s)
分 组别 n NIHSS ADL 治疗前 疗程结束后 治疗前 疗程结束后 研究组 60 20.07±2.01 6.47±0.95*# 40.67±10.10 70.39±7.30*# 对照组 60 20.23±1.95 8.66±1.11* 41.02±10.29 61.34±6.43* NIHSS: 美国国立卫生研究院卒中量表; ADL: 日常生活活动能力量表。与治疗前比较, *P < 0.05; 与对照组比较, #P < 0.05。
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表 3 2组血清hs-CRP及IGF-1水平比较(x±s)
组别 n hs-CRP/(mg/L) IGF-1/(ng/mL) 治疗前 疗程结束后 治疗前 疗程结束后 研究组 60 12.34±3.41 3.19±0.87*# 32.86±4.14 56.15±5.69*# 对照组 60 12.53±3.53 4.64±1.01* 33.20±4.24 45.26±5.11* hs-CRP: 超敏C反应蛋白; IGF-1: 胰岛素样生长因子-1。与治疗前比较, *P < 0.05; 与对照组比较, #P < 0.05。
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表 4 2组不良反应发生情况比较[n(%)]
组别 n 呕吐 转氨酶增高 皮疹 恶心 总计 研究组 60 3(5.00) 3(5.00) 1(1.67) 2(3.33) 9(15.00) 对照组 60 1(1.67) 1(1.67) 2(3.33) 3(5.00) 7(11.67)
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[1] 殷文明, 张小宁. 重组组织型纤溶酶原激活剂静脉溶栓治疗急性缺血性脑卒中疗效及安全性的Meta分析[J]. 中国全科医学, 2014, 17(14): 1629-1634. doi: 10.3969/j.issn.1007-9572.2014.14.016 [2] 何建军, 沈建, 佘晓春, 等. rTPA静脉溶栓联合动脉溶栓或支架取栓治疗急性缺血性脑卒中[J]. 江苏医药, 2017, 43(2): 146-147. https://www.cnki.com.cn/Article/CJFDTOTAL-YIYA201702024.htm [3] 魏玉玲. 大株红景天联合脑苷肌肽注射液治疗急性缺血性脑卒中的临床观察[J]. 中国医学工程, 2017, 25(3): 16-19. https://www.cnki.com.cn/Article/CJFDTOTAL-YCGC201703005.htm [4] 熊兵, 戴百良, 刘玲荣, 等. 依达拉奉注射液治疗急性脑梗死对神经功能缺损和日常生活活动能力的影响[J]. 中国现代医生, 2014, 52(2): 57-59. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYS201402025.htm [5] 袁州. 脉络宁注射液联合脑苷肌肽治疗急性缺血性脑血管病的临床研究[J]. 现代药物与临床, 2017, 32(12): 2363-2367. https://www.cnki.com.cn/Article/CJFDTOTAL-GWZW201712016.htm [6] 李光宁, 利伟江, 李金彩, 等. 重组组织型纤溶酶原激活剂治疗急性缺血性脑卒中临床疗效与安全性分析[J]. 中国药业, 2017, 26(9): 35-37. doi: 10.3969/j.issn.1006-4931.2017.09.011 [7] 徐冬娟, 程赣萍, 戴美芬, 等. 80岁以上急性缺血性脑卒中患者重组组织型纤溶酶原激活剂静脉溶栓治疗的有效性和安全性[J]. 中国综合临床, 2014, 30(8): 824-827. doi: 10.3760/cma.j.issn.1008-6315.2014.08.012 [8] 许育伟, 曾宪杰, 何文贞. 重组组织型纤溶酶原激活剂联合鼠神经生长因子对缺血性脑卒中患者疗效的影响[J]. 中国医药科学, 2018, 8(2): 237-239. doi: 10.3969/j.issn.2095-0616.2018.02.073 [9] 贾玉洁, 佟宇, 闵连秋. 脑苷肌肽对缺血性脑卒中老年患者的疗效及血清S100B、同型半胱氨酸和神经肽Y水平的影响[J]. 中国老年学杂志, 2014, 34(8): 2245-2246. doi: 10.3969/j.issn.1005-9202.2014.08.109 [10] 陈瑜, 杨昊, 徐锦凤. 脑苷肌肽对缺血性脑卒中患者的临床治疗作用研究[J]. 山西医药杂志, 2015, 44(11): 1273-1274. https://www.cnki.com.cn/Article/CJFDTOTAL-SXYY201511025.htm [11] 高雪武. 脑苷肌肽与丁苯酚治疗急性缺血性脑血管病的疗效比较[J]. 医学理论与实践, 2016, 29(8): 1024-1025. https://www.cnki.com.cn/Article/CJFDTOTAL-YXLL201608024.htm [12] 张良明, 王菲, 柏若玉. 脑苷肌肽对缺血性脑卒中患者的疗效及血清细胞因子水平的影响[J]. 卒中与神经疾病, 2017, 24(3): 241-242. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYS201703018.htm
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