阿替普酶联合尤瑞克林治疗心源性急性脑梗死回顾性队列研究OA

Objective To explore the therapeutic effect of Alteplase(rt-PA)combined with Urinary Kallidinogenase on cardio-genic acute cerebral infarction.Methods Medical records of 127 inpatients with cardiogenic acute cerebral infarction admitted to Luohe Central Hospital,Henan Province from January 2021 to January 2025 were collected.Complete supporting examination and treatment data were retained in all cases.According to different treatment plans,the patients were divided into the rt-PA group(using rt-PA alone)and the study group(rt-PA combined with Urinary Kallidinogenase),with 62 and 65 cases respectively.The levels of baseline data,hemorheology[low shear viscosity of whole blood,high shear viscosity of whole blood,fibrinogen(FIB)],cranial ultra-sound indicators[cerebral blood flow velocity of the middle cerebral artery(MCA),vertebral artery(VA),and basilar artery(BA)]and laboratory-related indicators[serum homocysteine(Hcy),vascular endothelial growth factor(VEGF),soluble intercellular adhe-sion molecule-1(sICAM-1)]were compared,and the clinical efficacy and safety indicators of the two groups were evaluated.Results After 14 days of treatment,the NIHSS score of the study group[(7.68±2.04)points vs.(9.01±2.16)points]was lower than that of the rt-PA group,and the NIHSS reduction rate[(50.29±6.21)％vs.(41.76±5.85)％]was higher than that of the rt-PA group.The thera-peutic effect grade was better than that of the rt-PA group.The differences were all statistically significant.At the end of the 3-month follow-up,the good prognosis rate of the study group was 80.00％(52/65),which was higher than that of the control group 62.90％(39/62),and the difference was statistically significant.After 14 days of treatment,the low shear viscosity,high shear viscosity and FIB of whole blood in the study group were all lower than those in the rt-PA group,and the cerebral blood flow velocities of MCA,VA and BA were all higher than those in the rt-PA group.The differences were statistically significant.After 14 days of treatment,the levels of serum Hcy and sICAM-1 in the study group were lower than those in the rt-PA group,and VEGF was higher than that in the rt-PA group.The differences were statistically significant.There was no statistically significant difference in the incidence of bleeding events between the two groups.Conclusion rt-PA combined with Urinary Kallidinogenase has a good clinical efficacy and safety in the treatment of cardiogenic acute cerebral infarction.It can improve the neurological function and prognosis of patients.The mechanism may involve improving hemorheology,promoting cerebral blood circulation,and regulating Hcy,VEGF,and sICAM-1 expression.