Clinical study of evolocumab combined with alteplase in treatment of acute cerebral infarction
Objective To explore the clinical study of evolocumab combined with alteplase in treatment of severe acute cerebral infarction with large atherosclerosis and Fazekas.Methods A total of 112 patients with severe acute cerebral infarction with large atherosclerosis and Fazekas scale were selected from the Department of Brain and Neurology of Tianjin Beichen Hospital from January 2021 to November 2022.All patients were divided into control group and treatment group according to random number table method,with 56 cases in each group.Patients in control group were given Alteplase for injection,calculated according to 0.9 mg/kg,the highest dosage should not exceed 90 mg,10% of the total dosage should be slowly pushed intravenously for 1 min,and the remaining 90% should be intravenous dribbled for 1 h.Patients in the control group were sc administered Evolocumab Injection on the basis of the control group,140 mg/time,once 2 weeks.Both groups were treated for 2 weeks.The clinical efficacy and symptom remission time of the two groups were observed,and the changes of lipid indexes and serum cytokines before and after treatment were compared between two groups.Results After treatment,the total effective rate of the treatment group was 92.86% ,which was significantly higher than that of control group(80.36% ,P<0.05).After treatment,the relief time of hemilimb weakness,mouth skew,swallowing abnormality and hemilimb numbness in the treatment group were significantly shorter than those in control group(P<0.05).After treatment,the levels of total cholesterol(TC),triglyceride(TG)and low density lipoprotein(LDL-C)in two groups weresignificantly decreased compared with before treatment,but the level of high density lipoprotein(HDL-C)was significantly increased(P<0.05).After treatment,the blood lipid level in treatment group was better than that in control group(P<0.05).After treatment,the levels of nerve injury 100β protein(S100β),serum intercellular adhesion factor(ICAM-1),neuron-specific enolase(NSE)and tumor necrosis factor α(TNF-α)in two groups were lower than before treatment(P<0.05).After treatment,the levels of S100β,ICAM-1,NSE and TNF-α in treatment group were lower than those in control group(P<0.05).Conclusion Evolocumab combined with alteplase has a good clinical effect in treatment of severe acute cerebral infarction with large atherosclerosis and Fazekas scale,and can accelerate the relief of clinical symptoms of patients,and can effectively regulate the blood lipid level of patients,reduce the inflammatory response of the body,which is worthy of reference.
Evolocumab InjectionAlteplase for injectionlarge atherosclerotic acute cerebral infarctionFazekas scaleTCTGLDL-CICAM-1NSE
NETL
NSTL
万方数据
维普
