摘要
目的比较不同剂量阿替普酶静脉溶栓治疗急性脑梗死的临床疗效。方法将138例急性脑梗死患者按随机数表法分为对照组和观察组,每组69例。对照组给予注射用阿替普酶0.9mg·kg^-1治疗,观察组给予注射用阿替普酶0.6mg·kg^-1治疗。观察2组治疗1、4周后神经功能缺损评分[国立卫生研究院卒中量表(NIHSS)评分]、日常生活活动能力(ADL)评分(Barthel指数评分)及随访6个月的预后(包括消化道出血、颅内出血、残疾、死亡等)的情况。结果观察组治疗1、4周后NIHSS评分、Barthel评分与对照组比较差异无统计学意义(P>0.05)。2组治疗4周后NIHSS评分均低于治疗1周后,Barthel评分均高于治疗1周后,差异有统计学意义(P<0.05);随访6个月,观察组消化道出血、颅内出血发生率和致残率、死亡率均低于对照组,差异有统计学意义(P<0.05)。结论低剂量阿替普酶静脉溶栓治疗急性脑梗死与常规剂量阿替普酶治疗的效果相当,但低剂量阿替普酶静脉溶栓治疗急性脑梗死可降低出血的发生率及致残率、死亡率。
Objective To compare the clinical effects of different doses of alteplase for intravenous thrombolysis in acute cerebral infarction. Methods A total of 138 patients with acute cerebral infarction were randomly treated with either 0.9 mg·kg^-1 alteplase(control group,n =69) or 0.6 mg·kg^-1 alteplase(observation group,n =69).Neurological functions were evaluated using the National Institutes of Health Stroke Scale(NIHSS) score and Barthel Activities of Daily Living(ADL) Index score after treatment for 1 and 4 weeks.In addition,the prognosis(gastrointestinal bleeding,intracranial hemorrhage,disability,death,etc.) was observed after 6 months of follow-up. Results There were no significant differences in the NIHSS and Barthel scores between the two groups after 1 and 4 weeks of treatment( P >0.05).However,compared with that measured after treatment for 1 week,the NIHSS score decreased and the Barthel score increased after treatment for 4 weeks in both groups( P <0.05).After 6 months of follow-up,the incidences of gastrointestinal bleeding,intracranial hemorrhage,disability and death in observation group were lower than those in control group( P <0.05). Conclusion Low-dose alteplase is equivalent to conventional dose of alteplase for intravenous thrombolysis in patients with acute cerebral infarction.Furthermore,low-dose alteplase can reduce the incidences of bleeding,disability and death.
作者
赵宏伟
ZHAO Hong-wei(Department of Neurology,Jizhou District People’s Hospital,Tianjin 301900,China)
出处
《实用临床医学（江西）》
CAS
2019年第7期5-7,共3页
Practical Clinical Medicine
关键词
急性脑梗死
阿替普酶
静脉溶栓
国立卫生研究院卒中量表评分
预后
acute cerebral infarction
alteplase
intravenous thrombolysis
National Institutes of Health Stroke Scale score
prognosis
