梁恩.rt-PA静脉溶栓治疗有效降低急性脑梗死患者外周血miR-34a水平及提高sirt1水平[J].内科急危重症杂志,2022,28(3):225-229
扫码阅读全文
|
| DOI：10.11768/nkjwzzzz20220312 |
| 中文关键词: 重组人组织型纤溶酶原激活剂 静脉溶栓 急性脑梗死 氧化应激 微小RNA-34a 沉默信息调节因子1 |
| 英文关键词: |
| 基金项目:广东省中医院局科研项目（No：20141092） |
|
| 摘要点击次数: 1384 |
| 全文下载次数: 1963 |
| 中文摘要: |
| 目的：探讨重组组织型纤溶酶原激活剂（rt-PA）静脉溶栓治疗对急性脑梗死患者氧化应激及外周血微小RNA-34a（miR-34a）、沉默信息调节因子1（sirt1）水平的影响。方法：选取105例急性脑梗死患者，按照随机数字表法分为溶栓组52例、常规组53例，剔除治疗期间死亡病例后，各50例。常规组接受常规治疗，溶栓组接受rt-PA静脉溶栓+除抗血小板聚集外的常规治疗。比较2组住院时间、机械通气时间、神志恢复时间，观察治疗前、后神经功能损伤情况、氧化应激相关指标、炎症因子水平和外周血单个核细胞中miR-34a、sirt1表达水平的变化。结果：溶栓组患者住院时间、机械通气时间、神志恢复时间显著短于常规组（P均＜0.05）。治疗后，2组患者美国国立卫生研究院卒中量表（NIHSS）评分降低，且溶栓组明显低于常规组（P均＜0.05）；2组患者血清丙二醛（MDA）、肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）水平较治疗前降低，且溶栓组低于常规组；超氧化物歧化酶（SOD）水平较治疗前升高，且溶栓组高于常规组（P均＜0.05）。治疗后2组患者外周血单个核细胞中miR-34a水平降低，且溶栓组低于常规组，sirt1水平升高，且溶栓组明显高于常规组（P均＜0.05）。结论：急性脑梗死患者应用rt-PA静脉溶栓治疗效果显著，可明显降低机体炎症反应，有效减轻氧化应激损伤，促进神经功能恢复。 |
| 英文摘要: |
| Objective: To investigate the effect of intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) on oxidative stress, microRNA-34a (miR-34a) and sirt1 in patients with acute cerebral infarction. Methods: A total of 105 patients with acute cerebral infarction were selected and divided into thrombolytic group (52 cases) and conventional group (53 cases) according to the random number table method. After excluding the dead cases during the treatment, there were 50 cases in each group. The conventional group received conventional treatment, while the thrombolytic group received rt-PA intravenous thrombolysis + conventional treatment except anti platelet aggregation. The hospitalization time, mechanical ventilation time and consciousness recovery time of the two groups were compared. The neurological function injury, oxidative stress related indexes, inflammatory factors and the expression levels of miR-34a and sirt1 in peripheral blood mononuclear cells were observed before and after treatment. Results: The hospitalization time, mechanical ventilation time and consciousness recovery time in thrombolytic group were significantly shorter than those in conventional group (all P<0.05). After treatment, the National Institute of Health stroke scale (NIHSS) scores in the two groups decreased, and those in thrombolytic group were significantly lower than those in conventional group (all P<0.05); the levels of malondialdehyde (MDA), tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) in the two groups were lower than those before treatment, and those in thrombolytic group 〖JP3〗were lower than those in conventional group; the level of superoxide dismutase (SOD) in thrombolytic group was higher than that in the conventional group (all P<0.05). After treatment, the level of miR-34a in the peripheral blood mononuclear cells of the two groups decreased, and that in thrombolytic group was lower than in conventional group, and the level of sirt1 increased, and that in thrombolytic group was significantly higher than in conventional group (all P<0.05). Conclusions: Intravenous thrombolysis with rt-PA is effective in patients with acute cerebral infarction, which can significantly reduce the inflammatory response, effectively reduce oxidative stress injury, and promote the recovery of neurological function. |
|
|
|
|
