摘要
目的:探讨不同用药剂量重组组织型纤溶酶原激活物(rt-PA)静脉溶栓治疗急性脑梗死的效果。方法:回顾性分析2018年1月—2021年1月在该院接受静脉溶栓治疗的急性脑梗死患者140例,按照剂量的不同分为小剂量组和标准剂量组,每组70例。小剂量组按照患者体重0.6 mg/kg提供药物,使用剂量≤60 mg,标准剂量组按照患者体重0.9 mg/kg提供药物,使用剂量≤90 mg,比较两组临床治疗效果、NIHSS评分、MRS评分、并发症发生率。结果:标准剂量组总有效率高于小剂量组,但差异无统计学意义(P>0.05)。两组治疗后30、60、90 d NIHSS评分低于治疗前,差异有统计学意义(P<0.05),但组间比较,差异无统计学意义(P>0.05)。两组治疗后24 h、3个月MRS 0~2分、MRS 3~6分占比比较,差异无统计学意义(P>0.05)。标准剂量并发症总发生率为12.86%,高于小剂量组的2.86%,差异有统计学意义(P<0.05)。结论:小剂量与标准剂量rt-PA静脉溶栓治疗急性脑梗死患者的疗效相近,均可有效改善急性脑梗死患者神经缺损程度及预后,但小剂量rt-PA药剂并发症发生率低,安全性较高。
Objective: To investigate the effect of intravenous thrombolysis of recombinant tissue-type plasminogen activator(rt-PA) in the treatment of acute cerebral infarction with different dosages. Methods: A retrospective analysis of 140 patients with acute cerebral infarction who received intravenous thrombolysis in the hospital from January 2018 to January 2021 was divided into low-dose group and standard-dose group according to the different doses, with 70 cases in each group. The lowdose group provides drugs based on the patient’s body weight 0.6 mg/kg, and the dose was ≤ 60 mg. The standard dose group provided drugs based on the patient’s weight 0.9 mg/kg and the dose ≤ 90 mg. The clinical treatment effects, NIHSS scores, and MRS scores,complication rate of the two groups were compared. Results: The total effective rate of the standarddose group was higher than that of the low-dose group, but the difference was not statistically significant(P>0.05). The 30 d, 60 d, and 90 d NIHSS scores of the two groups were lower than those before treatment, the difference was statistically significant(P <0.05), but the difference between the groups was not statistically significant(P >0.05). There was no statistically significant difference in the proportions of MRS 0-2 points and MRS 3-6 points between the two groups at 24 h and 3 months after treatment(P >0.05). The total incidence of complications in the standard-dose group was 12.86%, which was higher than that of the low-dose group of 2.86%, and the difference was statistically significant(P<0.05). Conclusion:The efficacy of low-dose and standard-dose rt-PA intravenous thrombolysis in patients with acute cerebral infarction is similar, and both can effectively improve the neurological deficit and prognosis of patients with acute cerebral infarction, but the low-dose rt-PA agent has a low complication rate and high safty.
作者
徐影
王晓杰
XU Ying;WANG Xiaojie(Department of Neurology,the Third Hospital of Fushun,Fushun 113004,Liaoning,China;Department of Neurology,Fushun Central Hospital,Fushun 113000,Liaoning,China)
出处
《中国药物滥用防治杂志》
CAS
2021年第5期802-805,共4页
Chinese Journal of Drug Abuse Prevention and Treatment
关键词
RT-PA
急性脑梗死
静脉溶栓
治疗时机
用药剂量
效果
rt-PA
Acute cerebral infarction
Intravenous thrombolysis
Timing of treatment
Dosage
Effect
