目的 观察重组组织型纤溶酶原激活药(rt-PA)静脉溶栓治疗发病4.5 h内急性脑梗死的疗效和安全性。方法 选择2012-07至2016-09武警北京总队医院收治的发病在4.5 h内急性脑梗死患者81例,根据患者及家属意愿分为溶栓组和对照组,溶栓组 58 例给予rt-PA 0.9 mg/kg静脉溶栓;对照组23 例采用抗血小板聚集药物等治疗;比较溶栓和常规治疗前和治疗后24 h、7 d及14 d 美国国立卫生研究院卒中量表 (NIHSS) 评分并记录不良反应。结果 溶栓组治疗后 24 h、7 d 及 14 d 时,NIHSS 评分较溶栓前及对照组均明显减少,差异有统计学意义(P<0.05)。溶栓组临床总有效率为86.21％,对照组为52.17％。溶栓组脑出血发生率为10.34％,其中症状性脑出血发生率3.45％;对照组脑出血发生率8.69％,其中症状性脑出血发生率4.35％。溶栓组和对照组病死率分别为5.17%和8.69％,差别无统计学意义(P=0.587)。结论 急性脑梗死患者4.5 h 内给予rt-PA 静脉溶栓治疗较常规治疗有效。
Abstract
Objective To explore the clinical efficiency and safety of recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis for patients within 4.5 hous of acute cerebral infarction onset.Methods Eighty-one patients with acute cerebral infarction within four and a half hours of onset were chosen and divided into the thrombolysis group and control group. The thrombolysis group was given rt-PA 0.9 mg/kg intravenous thrombolysis while the control group received conventional treatments such as antiplatelet aggregation.The National Institutes of Health Stroke Scale (NIHSS) scores were compared before treatment and after treatment of 24 hours,7 days and 14 days,and adverse reactions were recorded.Results NIHSS scores were significantly reduced in the thrombolysis group after 24 h,7 d and 14 d of treatment, and there was significant difference between the thrombolysis group and the control group (P<0.05) .The total clinical effective rate was 86.21% in the thrombolysis group, but was 52.17% in the control group. The intracerebral hemorrhage rate in the thrombolysis group was 10.34% and symptomatic intracerebral hemorrhage rate was 3.45%, but they were 8.69% and 4.35% respectively in the control group. Thrombolysis fatality in the thrombolysis group was 5.17% compared with 8.69% in the control group(P=0.587).Conclusions Rt-PA intravenous thrombolysis within 4.5h of cerebral infarction is more effective than conventional treatments.
关键词
重组组织型纤溶酶原激活剂 /
静脉溶栓 /
脑梗死
Key words
recombinant tissue type plasminogen activator(rt-PA ) /
intravenous thrombolysis /
cerebral infarction
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