Efficacy of recombinant human TNK tissue-type plasminogen activator thrombolysis combined with atorvastatin calcium in patients with acute cerebral infarction
Objective To study the efficacy of recombinant human TNK tissue-type plasminogen activator(rhTNK-tPA)thrombolysis combined with atorvastatin calcium in patients with acute cerebral infarction(ACI).Methods This study was a randomized controlled trial.A total of 90 ACI patients admitted to Department of Neurology,The Third Affiliated Hospital of Xi'an Medical University from May 2021 to December 2023 were selected as the study objects.The patients were divided into a control group(45 cases)and an observation group(45 cases)by the random number table method.The control group included 23 males and 22 females,aged(51.47±7.70)years,with a body mass index(BMI)of(24.12±2.69)kg/m2.The observation group included 26 males and 19 females,aged(53.18±8.45)years,with a BMI of(23.68±2.40)kg/m2.The control group was treated with rhTNK-tPA thrombolytic therapy,and the observation group was treated with atorvastatin calcium based on the control group.Both groups were treated for 2 weeks and followed up for 6 months.The clinical efficacy,serum levels of soluble intercellular adhesion molecule-1(sICAM-1),myelin basic protein(MBP),and lipoprotein-associated phospholipase A2(Lp-PLA2)before and after treatment,neurological function[National Institutes of Health Stroke Scale(NIHSS)score]and motor function[Fugl-Meyer Motor Function Assessment(FMA)score]before and after treatment and 3 months after treatment,occurrence of adverse drug reactions during treatment,and prognosis(death,vascular recanalization,and intracranial hemorrhage)during follow-up were compared between the two groups.Independent sample t test,x2 test and Fisher exact probability method were used for statistical analysis.Results The total effective rate of the observation group was higher than that of the control group[93.33％(42/45)vs.77.78％(35/45)](P＜0.05).After treatment,the levels of serum sICAM-1,MBP,and Lp-PLA2 in the observation group were lower than those in the control group[(291.45±22.81)μg/L vs.(308.62±23.50)μg/L,(2.24±0.41)μg/L vs.(2.58±0.46)μg/L,(142.71±20.56)μg/L vs.(157.31±19.40)μg/L](all P＜0.05).After treatment and 3 months after treatment,the NIHSS scores in the observation group were lower than those in the control group,and the FMA scores were higher than those in the control group[(5.56±1.08)points vs.(5.90±1.39)points,(3.64±0.75)points vs.(3.90±0.86)points,(68.73±10.46)points vs.(62.41±9.22)points,(79.44±10.34)points vs.(73.51±9.83)points](all P＜0.05).During treatment,there was no statistically significant difference in the total incidence of adverse reactions between the two groups(P＞0.05).After 6 months of follow-up,the vascular recirculation rate in the observation group was higher than that in the control group[95.56％(43/45)vs.82.22％(37/45)](P＜0.05).Conclusion rhTNK-tPA combined with atorvastatin calcium in the treatment of ACI patients can improve the clinical efficacy,serum sICAM-1,MBP,and Lp-PLA2 levels and exercise ability,and increase the vascular revascularization rate,which is safe and reliable.
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