Efficacy of rt-PA Intravenous Thrombolysis Combined with Neurointervention for Ischaemic Stroke in the Real World Based on MAPK/ERK Signalling Pathway,NIHSS Score,and Collateral Circulation Score
Objective To investigate the efficacy of recombinant tissue plasminogen activator(rt-PA)intravenous thrombolysis combined with neurointervention in the treatment of ischemic stroke in the real world based on the mitogen-activated protein kinase(MAPK)/extracellularly regulated protein kinase(ERK)signaling pathway,the National Institutes of Health stroke scale(NIHSS)score,and the collateral circulation score.Methods A total of 90 CIS patients admitted to Pingmei Shenma Medical Group General Hospital from January 2020 to January 2023 were selected as research objects,and were divided into single group(45 cases)and combined group(45 cases)by odd-even grouping method.The single group was given rt-PA thrombolytic therapy,and the combined group was given rt-PA thrombolytic therapy combined with nerve interventional therapy.The clinical efficacy,vascular revascularization rate,NIHSS,ADL score and collateral circulation score of the two groups were statistically compared.Cerebral hemodynamics[peripheral vascular resistance(Rv),pulse wave velocity(Wv)],serological indexes[S100 calcin-binding protein A12/Calgranin C(S100A12),high mobility group box-1 protein(HMGB1),hypersensitive C-reactive protein(hs-CRP)]and MAPK/ERK signaling pathway related factors[MAPK/ERK kinase(MEK),ERK1-β,ERK2-β]levels before and after treatment were compared between the two groups.The occurrence of adverse reactions was compared between the two groups.Results The total effective rate and vascular revascularization rate of combined group were higher than those of single group(P＜0.05).After thrombolysis,Rv,Wv and NIHSS scores in combination group were lower than those in single group,ADL scores and collateral circulation scores were higher than those in single group(P＜0.05).After thrombolysis,serum levels of S100A12,HMGB1 and hs-CRP in combination group were lower than those in single group(P＜0.05).After thrombolysis,the protein levels of MEK,ERK1-β and ERK2-β in combination group were lower than those in single group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion rt-PA combined with nerve interventional therapy for CIS is effective and safe.It can improve the rate of vascular recirculation,ability of daily living,nerve function and collateral circulation,and reduce the degree of inflammatory response,which may be related to the regulation of MAPK/ERK signaling pathway.
cerebral ischemic strokerecombinant tissue plasminogen activatornerve interventionneural function
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