目的 考察灯盏花素辅助阿替普酶治疗溶栓时间窗外急性脑梗死的疗效。方法 选取82例溶栓时间窗外急性脑梗死患者,随机分成实验组(40例)和对照组(42例)。对照组给予阿替普酶治疗,实验组在对照组基础上给予灯盏花素治疗。比较治疗前及治疗2周后,2组患者的神经功能缺损程度[国立卫生研究院卒中量表(NIHSS)]、脑梗死区域组织灌注情况[相对脑血容量(rCBV)、脑血流量水平(CBF)]、血流变学指标[高切全血黏度(HSBV)、低切全血黏度(LSBV)、血浆黏度(PV)、红细胞比容(HCT)]、氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)]。结果 治疗2周后,2组NIHSS评分及HSBV、LSBV、PV、HCT、MDA水平皆低于治疗前,且实验组低于同一时间对照组(P＜0.05);2组rCBV、CBF、SOD水平皆高于治疗前,且实验组高于同一时间对照组(P＜0.05)。结论 灯盏花素辅助阿替普酶治疗溶栓时间窗外急性脑梗死的治疗效果较好,有利于逆转患者神经功能缺损程度,增加梗死区域灌注量,改善患者血流情况,对其预后康复有利。

Objective To investigate the efficacy of breviscapine combined with alteplase in the treatment of acute cerebral infarction beyond thrombolytic time window. Methods A total of 82 patients with acute cerebral infarction beyond thrombolytic time window were randomly divided into experimental group (40 cases) and control group (42 cases). The control group was treated with alteplase, and the experimental group was treated with breviscapine on the basis of the control group. Before and 2 weeks after treatment, the degree of neurological deficit [National Institutes of Health Stroke Scale (NIHSS)], regional tissue perfusion of cerebral infarction [relative cerebral blood volume (rCBV), cerebral blood flow (CBF)], hemorheological indexes [high shear whole blood viscosity (HSBV), low shear whole blood viscosity (LSBV), plasma viscosity (PV), hematocrit (HCT)], the indexes of oxidative stress [malondialdehyde (MDA) and superoxide dismutase (SOD)] were compared between the two groups. Results After 2 weeks of treatment, NIHSS score, HBSV, LSBV, PV, HCT and MDA levels of the two groups were significantly lower than those before treatment, and those of the experimental group were significantly lower than the control group at the same time (P＜0.05). The rCBV, CBF and SOD levels of the two groups were significantly higher than those before treatment, while those of the experimental group was significantly higher than the control group (P＜0.05). Conclusions Breviscapine combined with alteplase in the treatment of acute cerebral infarction beyond thrombolytic time window had good therapeutic effect, which was beneficial to improve the degree of neurological deficit, increase the perfusion volume of infarcted area, improve the cerebral blood flow of patients, and was beneficial to the prognosis and rehabilitation.