摘要
目的 探讨超早期脑梗死患者接受不同剂量重组组织型纤溶酶原激活剂（rt-PA）静脉溶栓治疗后的疗效,探讨使用rt-PA的最佳剂量及安全性与可行性.方法 对我院2006-02-2012-02收治入院的300例发病6 h以内的脑梗死患者的临床资料进行回顾性分析,其中200例接受rt-PA治疗,并根据治疗剂量不同分为2组,A组100例给予rt-PA 0.9 mg/kg,B组100例给予rt-PA 0.6～0.8 mg/kg.C组对照100例患者未接受rt-PA治疗.以治疗前与治疗后11 d、21 d、90 d的NIHSS、Barthel指数为指标进行疗效评定.结果 A组、B组在治疗前、治疗后11 d、21 d及90 d的NIHSS、Barthel评分比较差异有统计学意义（P＜0.05）.A组、B组与C组90 d的神经功能缺失评分比较差异有统计学意义（P＜0.05）;A组、B组疗效明显高于C组,差异有统计学意义（P＜0.05）.A组基本痊愈＋显著进步69例,占 69.0%;B组77例,占77.0%;C组39例,占39%.B组优于A组;3组再发脑梗死发生率较高,C组高于A、B 2组;A、B 2组比较无明显差异.A组非症状性脑出血3例,症状性脑出血4例;B组非症状性脑出血2例,症状性脑出血3例.3组比较,P〈0.001;A与B比较,P〉0.05;A与C、B与C组比较,P〈0.001.结论 超早期脑梗死静脉应用rt-PA溶栓治疗安全有效.
Objective To investigate the curative effect of different doses of recombinant tissue plasminogen activator （rt- PA） in the treatment of patients with hyperacute cerebral infarction after intravenous thrombolytic, and to explore the optimal dose of rt-PA and its safety and feasibility. Methods From February 2006 to February 2012, clinical data of 300 cases of cerebral infarction patients within 6 hours in our hospital were analyzed retrospectively, 200 cases were treated by rt PA, and according to different doses were divided into two groups, 100 cases in group A were treated with rt-PA 0.9 mg/kg, group B of 100 patients for 0.6%0.8 mg/kg. Group C of 100 patients received no rt-PA treatment. Before treatment and after treatment of 11 d, 21 d, 90 d, NIHSS and Barthel index were detected for the evaluation of efficacy. Results In group A, group B before and after the treatment, the differences of NIHSS, BI scored on llth, 21st and 90th day was statistically significant. There was statistical significance of NIHSS score on 90th day in in group A, group B was significantly higher than that in group group A, group B and group C（P〈.0.05）. The curative effect C, the difference was statistically significant. In the group A, cure and significant progress of 69 cases, accounting for 69%. Group B were 77 cases, accounting for 77G. Group C were 39 cases, accounting for 39 %. Group B was better than group A; the recurrent cerebral infarction incidence in group C was higher than that in group A and B, there was no significant difference between group A and group B. In group A, there was 3 cases of asymptomatic cerebral hemorrhage, 4 cases of symptomatic cerebral hemorrhage; 2 cases of asymptomatic cerebral hemorrhage, 3 cases of cerebral hemorrhage in group B. Comparison of A and B, P〉0.05% Comparison of A and C, B and C,P〈0. 001. Conclusion Intravenous thrombolysis with rt-PA in the early treatment of cerebral infarction is safe and effective.
出处
《中国实用神经疾病杂志》
2013年第23期6-8,共3页
Chinese Journal of Practical Nervous Diseases
关键词
重组人组织纤维蛋白溶酶原激活剂
超早期
脑梗死
静脉溶栓
Recombinant human tissue plasminogen activator
Super early stage
Cerebral infarction
Intravenous thrombolytic therapy
