摘要
目的比较不同剂量重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗急性脑梗死的临床疗效及安全性。方法选取2014—2015年在徐州医科大学第二附属医院神经内科住院治疗的急性脑梗死患者101例,随机分为标准剂量组47例和低剂量组54例。发病4.5 h内,标准剂量组患者给予rt-PA 0.9 mg/kg治疗,低剂量组患者给予rt-PA0.6 mg/kg治疗。比较两组患者溶栓后24 h、7 d、3个月及6个月神经功能恢复情况和预后,记录两组患者溶栓后24h内颅内出血、院内死亡情况及不良反应发生情况。结果两组患者溶栓后24 h及6个月神经功能恢复良好率比较,差异无统计学意义(P>0.05);溶栓后7 d、3个月低剂量组患者神经功能恢复良好率低于标准剂量组(P<0.05)。两组患者溶栓后24 h、7 d、3个月、6个月预后良好率及溶栓后24 h内颅内出血发生率、院内病死率比较,差异均无统计学意义(P>0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论标准剂量(0.9 mg/kg)和低剂量(0.6 mg/kg)rt-PA静脉溶栓治疗急性脑梗死的临床疗效相当,安全性相似,而标准剂量(0.9 mg/kg)rt-PA有利于快速改善患者神经功能。
Objective To compare the clinical effect and safety of intravenous thrombolytic therapy for acute cerebral infarction between standard - and low - dose rt-PA. Methods From 2014 to 2015, a total of 101 inpatients with acute cerebral infarction were selected in the Department of Neurology, the Second Affiliated Hospital of Xuzhou Medical University, and they were randomly divided into A group （ n =47） and B group （n = 54）. Within 4. 5 hours of attack, patients of A group received standard- dose rt-PA （0. 9 mg/kg）, while patients of B group received low- dose rt-PA （0.6 mg/kg）. Recovery status of neurological function and prognosis after 24 hours, 7 days, 3 months and 6 months of treatment, incidence of intracranial hemorrhage within 24 hours after treatment, hospital death and adverse reactions were compared between the two groups. Results No statistically significant differences of proportion of patients with favorable neurological function was found between the two groups after 24 hours or 6 months of treatment （ P 〉 0. 05 ）, while proportion of patients with favorable neurological function of A group was statistically significantly better than that of B group after 7 days and 3 months of treatment, respectively （P 〈 0.05）. No statistically significant differences of proportion of patients with favorable prognosis was found between the two groups after 24 hours, 7 days, 3 months or 6 months of treatment, nor was incidence of intracranial hemorrhage within 24 hours after treatment or hospital fatality rate （ P 〉 0.05 ）. No statistically significant differences of incidence of adverse reactions was found betweenthe two groups （P 〉 0. 05）. Conclusion Standard - and low - close rt-PA have similar clinical effect anti safety in treating patients with acute cerebral infarction, while standard- dose rt-PA （0.9 mg/kg） is helpful to quickly improve the neurological function.
出处
《实用心脑肺血管病杂志》
2017年第3期62-65,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
脑梗死
重组组织型纤溶酶原激活剂
治疗结果
安全性
疗效比较研究
Brain infarction
Recombinant tissue pJasminogen activato
Treatment outcome
Safety
Comparativeeffectiveness research
