Rt-PA静脉溶栓治疗急性脑梗死的疗效及对血清IL-6，IL-17及VEGF水平的影响

目的:探讨重组组织纤溶酶原激活剂(Rt-PA)静脉溶栓治疗急性脑梗死的疗效及对血清白介素-6(IL-6)、IL-17及血管内皮生长因子(VEGF)水平的影响。方法:选择2014年8月至2016年8月我院接诊的86例急性脑梗死患者,通过随机数表法分为观察组(n=43)和对照组(n=43)。对照组给予常规治疗,观察组在对照组基础上进行Rt-PA静脉溶栓。比较两组的治疗效果、不良反应的发生情况、治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数、血清IL-6、IL-17及VEGF水平的变化。结果:治疗14 d后,观察组NIHSS评分显著低于对照组,Barthel指数明显高于对照组(P0.05);观察组在治疗后1 d、3 d、7 d、14 d时血清IL-6、IL-17水平均显著低于对照组(P0.05),治疗后1 d、3 d、7 d时血清VEGF水平明显高于对照组,治疗后14 d时血清VEGF水平显著低于对照组(P0.05)。观察组治疗后总有效率显著高于对照组(P0.05)。结论:在急性脑梗死患者中早期采用Rt-PA治疗的效果显著,可有效促进神经功能恢复,且安全性高,可能与其降低血清IL-6、IL-17、VEGF水平有关。

Efficacy of Rt-PA Intravenous Thrombolysis in Treatment of Acute Cerebral Infarction and Its Effects on Serum IL-6, IL-17 and VEGF Levels

ABSTRACT Objective: To study the curative efficacy of recombinant tissue-type plasminogen activator (Rt-PA) intravenous throm- bolysis in the treatment of acute cerebral infarction and its effects on the serum levels of interleukin-6 (IL-6), interleukin-17 (IL-17) and vascular endothelial growth factor (VEGF). Methods: 86 patients with acute cerebral infarction who were treated from August 2014 to August 2016 in our hospital were selected and divided into the observation group (n=43) and the control group (n=43) according to the random number table. The control group was treated with routine treatment, while the observation group was treated with Rt-PA intrave- nous thrombolysis on the basis of the control group. Then the treatment effect, incidence of adverse reactions, the National Institutes of Health Stroke Scale(NIHSS) scores, the Barthel index, the changes of serum IL-6, IL-17 and VEGF levels before and after treatment were compared between two groups. Results: After treatment, the NIHSS scores in the observation group was significantly lower than that of the control group, the Barthel index was significantly higher than that of the control group(P<0.05); on the 1st, 3rd, 7th, 14th day after treat- ment, the levels of serum IL-6, IL-17 in the observation group were significantly lower than those of the control group(P<0.05); on the 1st, 3rd, 7th day after treatment, the levels of serum VEGF was significantly higher than that of the control group, on the 14th day after treat- ment, the levels of serum VEGF was significantly lower than that of the control group(P<0.05); the total effective rate in the observation group was significantly higher than that of the control group(P<0.05). Conclusion: Early use of Rt-PA intravenous thrombolysis was well for the acute cerebral infarction, which could effectively promote the recovery of nerve function with high safety, which might be related to the reducing of serum levels of IL-6, IL-17 and VEGF.