Clinical effect of intravascular interventional therapy in the treatment of acute ischemic stroke and its influence on cognitive function, cerebral hemodynamics and inflammatory factors

血管内介入治疗急性缺血性卒中的临床疗效及其对认知功能、脑血流动力学和炎症因子的影响

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Abstract

OBJECTIVES: To evaluate the clinical effect of intravascular interventional therapy in the treatment of acute ischemic stroke and its influence on cognitive function, cerebral hemodynamics and inflammatory factors as well as its clinical significance. METHODS: Eighty patients with acute ischemic stroke admitted to Tangxian people's Hospital from January 2018 to January 2020 were randomly divided into two groups. Patients in the control group were treated with conventional thrombolytic therapy on the basis of basic treatment, while patients in the experimental group were given intravascular interventional treatment on the basis of conventional treatment. Clinical effect, recovery of cognitive function and activities of daily living, improvement of cerebral hemodynamics indexes, and changes of inflammatory factors before and after treatment were analyzed by combining NIHSS score and symptom improvement before and two months after treatment, respectively. RESULTS: The effective rate of the experimental group was 82.5% after treatment, and that of the control group was 60%, with a statistically significant difference (P =0.02). Mini-mental State Examination (MMSE) and Barthel scores of the experimental group were significantly improved compared with those of the control group after treatment, with statistically significant differences between the two groups (P=0.00). The mean cerebral vascular blood flow (Qm) of the experimental group increased significantly after treatment compared with that of the control group, while vascular characteristic impedance (ZCV) and peripheral resistance (Rv) decreased significantly in the experimental, with a statistically significant difference (ZCV, P=0.01; Rv, P=0.05); After treatment, TNF- A, CRP, IL-6 and other indicators in the experimental group were significantly lower than those in the control group, with statistically significant differences (P=0.00). CONCLUSIONS: Intravascular interventional therapy is an effective treatment regimen for acute ischemic stroke boasting a variety of advantages over conventional thrombolysis, such as significant symptom improvement, high efficacy, favourable recovery of cognitive function and activities of daily living, improvement of cerebral hsemodynamic indicators, and significant reduction of inflammatory cytokine levels.

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