| Objective By comparing the NIHSS and m RS scores of the head-down title bed rest group(experimental group)and the conventional treatment group(control group)before and after treatment,observe the treatment effect of the head-down position on acute large atherosclerotic cerebral infarction,and detect the serum levels of the two groups before and after treatment.Changes in tumor necrosis factor-α(TNF-α),lipoprotein-associated phospholipase A2(Lp-PLA2),and D-dimer(D-Dimer)levels.Methods From December 2019 to December 2020,100 patients with acute large atherosclerotic cerebral infarction who were admitted to the Department of Neurology,Affiliated Central Hospital of Shenyang Medical College,were admitted within 72 hours,and were divided into head-down title bed rest groups according to the random number table method.Compared with the conventional treatment group,each group has50 cases.Both groups of patients were given regular basic treatments that followed the guidelines,such as improving cerebral circulation,nourishing brain nerves,anti-platelet aggregation,lowering lipids and stabilizing plaques.The head-down title bed rest group was given head-down title bed rest treatment on this basis.On the first day of admission,the 7±1,12±2,and 90±7 days of treatment,NIHSS scores were performed on the two groups of patients,and m RS scores were performed on the first and 90±7days of admission,Collect data,perform statistical analysis,compare the changes in the two groups of values,and observe the clinical effects of head-down tilt bed rest treatment in patients with acute large atherosclerotic cerebral infarction.The serum levels of TNF-α,LP-PLA2,and D-Dimer were detected on the first and seventh days of admission.Results Before treatment,the NIHSS scores of the head-down tilt bed rest group and the conventional treatment group were compared,and there was no statistically significant difference between the two groups,P>0.05;On the 7±1 day of treatment,the NIHSS scores of the head-down tilt bed rest group and the conventional treatment group were lower than before treatment,and the head-down tilt bed rest group was lower [(8.420±4.301)points vs(8.880 ± 3.998)points],but there was a difference No statistical significance,P>0.05;On the 12 th day of treatment,the NIHSS scores of the head-down tilt bed rest group and the conventional treatment group were compared [(5.760±2.403)points vs(6.840±2.964)points],the difference was statistically significant,P <0.05;On day 90±7,the NIHSS scores of the head-down tilt bed rest group and the conventional treatment group were significantly lower than before treatment,and the experimental group was significantly lower than the control group [(3.44±2.09)points vs(5.30±3.07)points],The results are significantly different,P<0.01;Comparing the NIHSS scores of the head-down tilt bed rest group on the first day of admission,7±1 days,12± 2 days,and 90 ± 7 days of treatment,the difference was statistically significant,P<0.05;Comparing the NIHSS scores of the conventional treatment group on the first day of admission,7±1 days,12±2 days,and 90±7 days of treatment,the difference was statistically significant,P<0.05.Before treatment,comparing the m RS scores of the head-down tilt bed rest group and the conventional treatment group,there was no statistically significant difference between the two groups,P>0.05;On day 90±7,the m RS scores of the head-down tilt bed rest group and the conventional treatment group were lower than before treatment,and the head-down tilt bed rest group decreased more significantly than the conventional treatment group [(2.160 ± 1.218)points vs(2.660±1.255)points],the difference It is statistically significant,P<0.05;On day 90±7,the m RS score of the head-down tilt bed rest group was compared with the m RS score on the first day of admission,the results were significantly different,P<0.01;The m RS score of the conventional treatment group was compared with the m RS score on the first day of admission,and the results were also significantly different,P<0.01.The serum levels of TNF-α,Lp-PLA2 and D-Dimer in the head-down tilt bed rest group were significantly lower than before treatment on the 7th day after head-down tilt bed rest treatment [TNF-α(40.567±5.849)pg/ml vs(48.722±9.400)pg /ml,Lp-PLA2(113.800±33.198)ng/ml vs(204.110±40.020)ng/ml,D-Dimer(0.574±0.429)mg/L vs(0.952 ± 0.888)mg/L],the results are significantly different,P<0.01;The serum levels of TNF-α and Lp-PLA2 in the routine treatment group were lower than before treatment on the 7th day [TNF-α(44.934±8.139)pg/ml vs(48.722±9.400)pg/ml,Lp-PLA2(138.436)±36.560)ng/ml vs(198.452±34.771)ng/ml,the difference is statistically significant,P<0.05,but the head-down title bed rest group has a more significant reduction than the conventional treatment group;On the 7th day of treatment,the serum D-Dimer content had a decreasing trend compared with that before treatment[D-Dimer(0.789±0.580)mg/L vs(0.856±0.738)mg/L],but the difference was not statistically significant,P >0.05.Before treatment,the serum TNF-α,Lp-PLA2 and D-Dimer levels were compared between the head-down tilt bed rest group and the conventional treatment group.There was no statistically significant difference between the two groups,P>0.05;On the 7th day of treatment,the serum levels of TNF-α,Lp-PLA2 and D-Dimer between the head-down tilt bed rest group and the conventional treatment group were compared [TNF-α(40.567±5.849)pg/ml vs(44.934±8.139)pg /ml,Lp-PLA2(113.800 ± 33.198)ng/ml vs(138.436 ± 36.560)ng/ml,D-Dimer(0.574±0.429)mg/L vs(0.789±0.580)mg/L],the difference is statistically significant Significance,P<0.05.Conclusions Head-down tilt bed rest can significantly reduce the NIHSS score and m RS score of patients with acute large atherosclerotic cerebral infarction,promote the recovery of the patient’s neurological function,and improve the patient’s prognosis;after head-down tilt bed rest treatment,the serum levels of TNF-α and Lp-PLA2 The significant decrease in content may be related to the head-down tilt bed rest treatment inhibiting the inflammatory response after acute large atherosclerotic cerebral infarction;the level of D-Dimer in the serum of patients after the head-down tilt bed rest treatment was significantly reduced,which may be related to the head-down tilt bed rest treatment that can improve blood coagulation and fibrinolysis in patients with acute large atherosclerotic cerebral infarction The unbalanced state of the system is related. |
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