摘要
目的 探究急性缺血性卒中患者采用不同剂量阿替普酶静脉溶栓治疗后对神经功能的改善效果.方法 选取120例急性缺血性卒中患者作为研究对象,根据入院时间先后将患者分成观察组和对照组各60例,观察组患者使用低剂量阿替普酶（0.6 mg/kg）治疗,对照组采用标准剂量（0.9 mg/kg）治疗,观察并记录两组患者临床疗效、不良事件发生概率、治疗前后NIHSS评分以及mRS评分变化情况,分析比较.结果治疗前,两组NIHSS评分差异无统计学意义（t=0.288 0,P=0.773 9）;接受治疗3 d后,对照组NIHSS评分与治疗前相比降低,且低于同时期观察组患者,两组差异有统计学意义（t=0.778 5,P=0.000 0）.两组治疗前mRS评分差异无统计学意义（t=0.801 0,P=0.424 7）;治疗90 d后,两组mRS评分降低,差异有统计学意义（t=6.811 5,P=0.000 0）.治疗后,观察组1例患者脑出血,对照组3例,两组差异无统计学意义（χ2=1.034 5,P=0.309 1）;观察组病死率11.47％,对照组病死率1.67％,两组差异有统计学意义（χ2=4.821 4,P=0.028 1）;观察组预后良好率45.00％,对照组预后良好率68.33％,差异有统计学意义（χ2=6.651 6,P=0.009 9）.结论 标准剂量阿替普酶比低剂量治疗急性缺血性卒中疗效更好,患者神经功能缺损状况得到有效改善,神经功能恢复较好,预后良好,值得广泛推荐使用.
Objective To investigate the effect of intravenous thrombolysis with different doses of alteplase on neurological function in patients with acute ischemic stroke.Methods 120 patients with acute ischemic stroke were selected as the research subjects.According to the admission time,the patients were divided into the observation group and the control group,60 patients in each group.The observation group was treated with low dose alteplase（0.6mg/kg）,the control group was given standard dose（0.9mg/kg）.The clinical curative effect,incidence rate of adverse event,NIHSS score and mRS score before and after treatment were observed and recorded in the two groups.Results Before treatment,there was no significant difference between the two groups in NIHSS score（t=0.288 0,P=0.773 9）.After treatment for 3 days,the NIHSS score of the control group decreased compared with before treatment,and was lower than that of the observation group at the same period,there was significant difference between the two groups（t=0.778 5,P=0.000 0）.Before treatment,the mRS score between the two groups had no siginificant difference（t=0.801 0,P=0.424 7）.After treatment for 90 days,the mRS score of the two groups decreased,the difference was statistically significant（t=6.811 5,P=0.000 0）.After treatment,1 patient with cerebral hemorrhage was observed in the observation group,while 3 cases in the control group,the difference between the two groups was not statistically significant（χ2=1.034 5,P=0.309 1）.The mortality of the observation group was 11.47%,which of the control group was 1.67%,there was significant difference between the two groups（χ2=4.821 4,P=0.028 1）.The good prognosis rate of the observation group was 45%,which of the control group was 68.33%,the difference was significant between the two groups （χ2=6.651 6,P=0.009 9）.Conclusion Standard dose of alteplase in the treatment of acute ischemic stroke has better efficacy than low-dose alteplase,it has improved conditions of neurological deficits in pa
出处
《中国基层医药》
CAS
2017年第17期2655-2659,共5页
Chinese Journal of Primary Medicine and Pharmacy
关键词
卒中
脑缺血
阿替普酶
血栓溶解疗法
Stroke
Brain ischemia
Alteplase
Thrombolytic therapy
