摘要
目的观察重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗对伴或不伴心房纤颤(房颤)的急性脑梗死患者的疗效。方法应用rt-PA对病程<6 h的66例无房颤的急性脑梗死患者(非房颤组)和21例伴房颤急性脑梗死患者(房颤组)进行静脉溶栓治疗;观察溶栓后两组脑出血的发生率、死亡率;采用美国国立卫生研究院卒中量表(NIHSS)在溶栓前及溶栓后24 h、7 d对患者进行神经功能缺损程度评分;溶栓后90d使用改良Rankin(mRN)量表评估其综合生活能力。结果两组治疗后24 h及7 d的NIHSS评分均较治疗前显著降低(均P<0.01),两组治疗后各时间点NIHSS及mRN评分差异无统计学意义。房颤组脑出血发生率(28.6%)高于与非房颤组(16.7%),但差异无统计学意义;死亡率(19.0%)显著高于非房颤组(1.5%)(P<0.05)。结论伴房颤的急性脑梗患者rt-PA静脉溶栓治疗有效,但溶栓后脑出血发生率及死亡率高于不伴房颤的急性脑梗死患者。
Objective To observe the curative effect of intravenous thrombolytic therapy with recombinant tissue plasminogen activator（rt-PA） on acute cerebral infarction（ACI） patients with or without arterial fibrillation（AF）.Methods Sixty-six ACI patients without AF（non-AF group） and 21 ACI patients with AF（AF group）,which course of ACI was all 6 h were treated by intravenous thrombolytic therapy with rt-PA.The incidence of intracerebral hemorrhage and mortality after thrombolysis were observed in the two groups.The nerve function defect was assessed by national institutes of health stroke scale（NIHSS） at pre-therapy and 24 h,7 d post-therapy.Comprehensive ability of living was assessed by modified Rankin（mRN） scale at 90 d post-therapy.Results Compared with pre-therapy,NIHSS scores of the two groups were significantly reduced post-therapy in 24 h and 7d（all P 0.01）.The differences of NIHSS and mRN scores between the two groups were no statistically significant at each time point post-therapy.The incidence of intracerebral hemorrhage in AF group（28.6%） was higher than non-AF group（16.7%）,but the difference was no statistically significant.The mortality in AF group（19.0%） was significantly higher than non-AF group（1.5%）（P0.05）.Conclusions The intravenous thrombolytic therapy by rt-PA on ACI patients with AF is effective.But the incidence of cerebral hemorrhage and mortality are higher than the ACI patients without AF.
出处
《临床神经病学杂志》
CAS
北大核心
2012年第6期455-457,共3页
Journal of Clinical Neurology
关键词
急性脑梗死
溶栓治疗
重组组织型纤溶酶原激活剂
心房纤颤
acute cerebral infarction
thrombolytic therapy
recombinant tissue type plasminogen activator
atrial fibrillation
