摘要
目的探讨椎-基底动脉系统脑梗死患者不同时间窗重组组织型纤溶酶原激活剂（recombinant tissue plasminogen activator,rt-PA）静脉溶栓治疗的临床疗效。方法回顾性分析50例椎-基底动脉系统脑梗死患者临床资料,按溶栓治疗时间窗分为〈4.5 h组和4.5~9 h组,每组25例。比较两组患者神经功能缺损量表（national institutes of health stroke scale,NIHSS）评分、Barthel指数（Barthel index,BI）评分、改良Rankin量表（modified Rankin scale,mRS）评分及脑出血发生率。结果与治疗前相比较,治疗后14 d、30 d、90 d时〈4.5 h组和4.5~9 h组NIHSS评分和BI评分均显著升高,组间比较差异显著（P〈0.05）。治疗前及治疗后14 d、30 d、90 d,两组患者NIHSS评分和BI评分比较均无统计学差异（P〉0.05）。治疗后90 d,两组患者mRS评分比较无统计学差异（P〉0.05）。〈4.5 h组和4.5~9 h组BI评分脑出血发生率分别为4.0%（1/25）、8.0%（2/25）,组间比较差异无统计学意义。结论椎-基底动脉系统脑梗死患者发病9 h内应用rt-PA静脉溶栓治疗是安全有效的。
Objective To evaluate the effect of recombinant tissue plasminogen activator（ rt-PA） intravenous thrombolytic therapy for vertebrobasilar system cerebral infarction within different time windows. Methods The clinical data of50 patients with vertebrobasilar system cerebral infarction were retrospectively analyzed. According to thrombolysis therapy time window,the all the patients were divided into 4. 5 h group and 4. 5 ~ 9 h group,25 cases in each group. The national institutes of health stroke scale（ NIHSS） score,Barthel index（ BI） score,modified Rankin scale（ mRS） score and cerebral hemorrhage rate were compared between the two groups. Results After 14 d,30 d and 90 d of treatment 14 d,30 d and 90 d,the NIHSS score and BI score of 4. 5 h group and 4. 5 ~ 9 h group were significantly higher than before treatment,the difference showed statistically significant（ P 0. 05）. After 14 d,30 d and 90 d of treatment 14 d,30 d and 90 d,the NIHSS score and BI score of 4. 5 h group and 4. 5 ~ 9 h group were not statistically different（ P 0. 05）. After 90 d treatment90 d,the mRS score of 4. 5 h group and 4. 5 ~ 9 h group were not statistically different（ P 0. 05）. The cerebral hemorrhage rate of 4. 5 h group and 4. 5 ~ 9 h group respectively was 4. 0%（ 1 /25） and 8. 0%（ 2 /25）,the difference showed statistically significant（ P 0. 05）. Conclusion Intravenous thrombolytic therapy with rt-PA is effective and safe within 6hours from symptom onset of acute vertebrobasilar artery infarction.
出处
《中风与神经疾病杂志》
CAS
北大核心
2016年第1期64-66,共3页
Journal of Apoplexy and Nervous Diseases
关键词
重组组织型纤溶酶原激活剂
椎-基底动脉系统
脑梗死
静脉溶栓
Recombinant tissue plasminogen activator
Vertebrobasilar system
Cerebral infarction
Intrave nous thrombolytic
