摘要
目的探讨早期急性脑梗死(ACI)采用重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗的疗效与安全性。方法选取发病4. 5 h内于神经内科接受治疗的80例ACI患者作为研究对象,根据随机数字表法分组,观察组40例患者给予rt-PA静脉溶栓治疗,对照组40例患者给予奥扎格雷钠注射液常规治疗。分析2组患者治疗前后Barthel指数(BI)评分、美国国立卫生研究院卒中量表(NIHSS)评分、治疗总有效率及不良反应发生情况。结果与治疗前相比较,2组患者治疗后14 d BI评分均显著升高,但观察组BI评分升高更为显著(P <0. 05);与治疗前相比较,2组患者治疗后24 h、14 d的NIHSS评分均显著降低,但观察组NIHSS评分降低更显著(P <0. 05)。观察组治疗14 d的总有效率90. 00%(36/40)显著高于对照组77. 50%(31/40)(P <0. 05);观察组发生症状性颅内出血1例、血管再闭塞1例,对照组发生症状性颅内出血2例、血管再闭塞2例、消化道出血1例、心功能不全1例,观察组不良反应发生率5. 00%(2/40)显著低于对照组15. 00%(6/40)(P <0. 05)。结论 ACI患者发病4. 5 h内采用rt-PA静脉溶栓治疗疗效可靠,可显著改善患者神经功能,且不良反应少。
Objective To discuss the efficacy of recombinant tissue plasminogen activator( rt-PA) on intravenous thrombolysis for early acute cerebral infarction( ACI) and its safety. Methods A total of 80 ACI patients within 4. 5 h onset of disease were selected as study subjects,and were divided into control group( 40 cases) and observation group( 40 cases) according to random number table method. The patients in the observation group were treated with rt-PA intravenous thrombolysis,while the control group received routine treatment with Ozagrel Sodium Injection. The Barthel index( BI) score,National Institute of Health Stroke Scale( NIHSS) score,total effective rate and adverse reactions were analyzed before and after treatment in the two groups. Results Compared with before treatment,the patients in the two groups had significantly increased BI scores at 14 d,and significantly increased NIHSS scores at the 24 h and 14 d after treatment,but the observation group changed more significantly( P < 0. 05). After treatment,the 14 d total effective rate in the observation group was significantly higher than that in the control group [90%( 36/40) vs. 77. 50%( 31/40),P <0. 05]. There were 1 case with symptomatic intracranial hemorrhage and 1 with vascular re occlusion in the observation group. There were 2 cases with symptomatic intracranial hemorrhage,2 with vascular restenosis,1 with digestive tract bleeding,and 1 with cardiac insufficiency in the control group,and the incidence of adverse reactions in the observation group was significantly lower than that in the control group[5 %( 2/40) vs. 15 %( 6/40),P < 0. 05). Conclusion The curative effect of rt-PA intravenous thrombolysis in ACI patients within 4. 5 h onset is reliable,and it can improve the neurological function of the patients,and has less adverse reactions.
作者
吴蓓蓓
陈旭
WU Beibei;CHEN Xu(Department of Neurology, Shanghai Eighth People′s Hospital, Shanghai, 200235)
出处
《实用临床医药杂志》
CAS
2019年第5期42-45,共4页
Journal of Clinical Medicine in Practice
关键词
急性脑梗死
重组组织型纤溶酶原激活剂
静脉溶栓
acute cerebral infarction
recombinant tissue plasminogen activator
intravenous thrombolysis
