临床误诊误治2026，Vol.39Issue(12)：65-71,7.DOI:10.3969/j.issn.1002-3429.2026.12.011
不同时间窗替奈普酶静脉溶栓治疗对急性脑梗死患者近期疗效及对血清应激因子水平的影响
Short-term curative effect of intravenous Tenecteplase thrombolysis at different time windows and its impacts on the levels of serum stress factors in patients with acute cerebral infarction
摘要
Abstract
Objective To investigate short-term curative effect of intravenous Tenecteplase thrombolysis at different time windows and its impacts on levels of serum stress factors in patients with acute cerebral infarction(ACI).Methods A retrospective analysis was conducted on 150 ACI patients who received emergency intravenous thrombolysis with Tenecteplase(interval from admission to thrombolysis ≤4.5 h)at the First Central Hospital of Baoding city between January and December 2024.According to different thrombolytic time windows,they were divided into short-time group(＜3 h,n=68)and long-time group(3-4.5 h,n=82).The related indexes of disease outcomes[National Institutes of Health Stroke Scale(NIHSS),Modified Rankin Scale(mRS)],self-care ability[Modified Barthel Index(MBI)],serum oxidative stress markers[superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),malondialdehyde(MDA)],serum inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),interleukin-1β(IL-1β),matrix metalloproteinase-9(MMP-9)]and adverse events(incidence of hemorrhagic transformation,cardiovascular events and death within 14 d after thrombolysis)in the two groups were observed before and after thrombolysis.Results NIHSS score at 7 d after thrombolysis and mRS score at 90 d after thrombolysis were decreased in both groups,which were lower in short-time group(P＜0.05,P＜0.01).At 7 d after thrombolysis,MBI was increased in both groups,which was higher in short-time group(P＜0.01).At 7 d after thrombolysis,the levels of serum SOD and GSH-Px were increased,while MDA was decreased in both groups(P＜0.05);the former were higher in short-time group,and the latter was lower in short-time group(P＜0.01).At 7 d after thrombolysis,the levels of serum inflammatory factors(hs-CRP,IL-1β,MMP-9)were decreased in both groups(P＜0.05),which were lower in short-time group than in long-time group(P＜0.01).The absolute values of the differences in the above indexes before and after treatment in the short-time group were greater than those in the long-time group(P＜0.05).At 14 d after thrombolysis,there was no significant difference in the incidence of adverse events between the two groups(P＞0.05).Conclusion Intravenous Tenecteplase thrombolysis can significantly improve short-term nerve function and activities of daily living,effectively regulate oxidative stress response,and down-regulate inflammatory factors to improve prognosis of ACI patients.Intravenous thrombolysis with Tenecteplase within 3 h after onset has better clinical effect and regulation effect on serum stress factors.关键词
急性脑梗死/溶栓时间窗/替奈普酶/美国国立卫生研究院卒中量表评分/改良Rankin量表评分/超氧化物歧化酶/超敏C反应蛋白Key words
acute cerebral infarction/thrombolytic time window/Tenecteplase/National Institutes of Health Stroke Scale score/Modified Rankin Scale score/superoxide dismutase/high-sensitivity C-reactive protein引用本文复制引用
崔妍莉,李静,张静,钱倩,白艳梅..不同时间窗替奈普酶静脉溶栓治疗对急性脑梗死患者近期疗效及对血清应激因子水平的影响[J].临床误诊误治,2026,39(12):65-71,7.基金项目
保定市科技计划项目(2441ZF075) （2441ZF075）
