摘要
目的探讨重组组织型纤溶酶原激活剂(rt-PA)静脉治疗高龄轻型脑卒中(CAV)患者的临床效果。方法选取2016年1月~2018年12月六安市人民医院收治的发病时间≤4.5 h且年龄>60岁的82例急性轻型CAV患者(NIHSS≤5分)作为研究对象,按照治疗方法的不同分为溶栓组(43例)和对照组(39例)。溶栓组采取rt-PA溶栓治疗,对照组采取阿司匹林与硫酸氢氯吡格雷片联合抗血小板聚集治疗。比较两组的一般资料、溶栓后24 h、3、7及14 d NIHSS评分、90 d神经功能恢复良好率(mRS<2分)的差异。结果溶栓组治疗后24 h、治疗后3、7、14 d的NIHSS评分低于对照组,差异均有统计学意义(P<0.05);溶栓组90 d mRS评分良好预后率高于对照组,差异有统计学意义(P<0.05);溶栓组早期发生神经功能恶化率为7.0%(3/43),低于对照组的23.1%(9/39),差异有统计学意义(P<0.05)。结论rt-PA静脉治疗有助于高龄轻型CAV患者神经功能的恢复,并能降低其早期神经功能恶化率。
Objective To investigate the clinical effect of intravenous thrombolysis in elderly mild ischemic stroke(CAV)patients with recombinant tissue plasminogen activactor(rt-PA).Methods A total of 82 patients with acute mild CAV(NIHSS≤5 points)who were treated in Lu′an People′s Hospital had an onset time of≤4.5 hours and age>60 years from January 2016 to December 2018 were selected and divided into thrombolysis group(43 cases)and control group(39 cases)according to the different treatment methods.Thrombolytic group treated with rt-PA,the control group used Aspirin and Clopidogrel Hydrogen Sulfate.The date in baseline data,NIHSS scores at 24 h,3,7,14 d after thrombolysis,90 d modified rankin scale(mRS<2 points)between the two groups were compared.Results 24 h,3,7 and 14 d NIHSS scores in the thrombolytic group were all lower than those in control group,the difference was statistically significant(P<0.05).The good prognosis(mRS<2 points)in the thrombolytic group at 90 d was higher than that in the control group,the difference was statistically significant(P<0.05).Early neurological deterioration rate in the thrombolytic group was lower than that of the control group(7.0%[3/43]vs 23.1%[9/39]),the difference was statistically significant(P<0.05).Conclusion Rt-PA intravenous thrombolysis can improve the neurological function in elderly patients with mild CAV and reduce the incidence of early neurological deterioration.
作者
李苇
谭守文
梁正玲
严兴亚
丛光燕
吕鸿燕
LI Wei;TAN Shou-wen;LIANG Zheng-ling;YAN Xing-ya;CONG Guang-yan;LYU Hong-yan(Graduate School,Bengbu Medical College,Anhui Province,Bengbu 233000,China;Department of Neurology,Lu′an People′s Hospital,Anhui Province,Lu′an 237005,China)
出处
《中国当代医药》
2019年第36期103-106,共4页
China Modern Medicine
