Treatment efficacy of arterial urokinase thrombolysis combined with mechanical thrombectomy for acute cerebral infarction and its influence on neuroprotective factors and factors for neurological injury.

医学 神经保护 尿激酶 溶栓 血管内皮生长因子 神经营养因子 胶质纤维酸性蛋白 烯醇化酶 内科学 脑梗塞 麻醉 胃肠病学 缺血 血管内皮生长因子受体 免疫组织化学 心肌梗塞 受体
作者
Jingfeng Liu,Ling Tian,Na Li
出处
期刊:American Journal of Translational Research [e-Century Publishing Corporation]
卷期号:13 (4): 3380-3389
标识
摘要

Objective This study was designed to explore the treatment efficacy of arterial urokinase thrombolysis combined with Solitaire AB stent for acute cerebral infarction (ACI) and its influence on neuroprotective factors and factors for neurological injury. Methods We randomly assigned 90 patients with ACI to receive arterial urokinase thrombolysis combined with Solitaire AB stent thrombectomy (observation group, OG) or to receive arterial urokinase thrombolysis (control group, CG). The two groups were compared in the National Institutes of Health Stroke Scale (NIHSS) score, activities of daily living (ADL) score, vascular recanalization rate 1 month after treatment, and serum levels of neuroprotective factors (insulin-like growth factor-I (IGF-1), neurotrophic factor (NTF), vascular endothelial growth factor (VEGF), and brain-derived neurotrophic factor (BDNF)) and factors for neurological injury (neuron-specific enolase (NSE), S100B protein (S100B), ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1), glial fibrillary acidic protein (GFAP)) before treatment and the day after treatment. Results The overall treatment response rate and vascular recanalization rate 1 month after treatment were markedly higher in OG than in CG (P 0.05). The day after treatment, serum levels of IGF-1, NTF, VEGF, and BDNF in both groups increased while levels of NSE, S100B, UCH-L1, and GFAP in them decreased, with higher levels of IGF-1, NTF, VEGF, and BDNF, and lower levels of NSE, S100B, UCH-L1, and GFAP in OG than in CG (all P Conclusion Arterial urokinase thrombolysis combined with Solitaire AB stent thrombectomy can enhance the treatment efficacy for ACI, stimulate the release of neuroprotective factors, and suppress the release of factors for neurological injury, without aggravating the treatment risk.

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