论著 Original Article

阿替普酶静脉溶栓治疗发病3~4.5 h急性脑梗死的疗效及安全性研究

Published at: 2016年第36卷第12期

尚俊英 1 , 李雪峰 2 , 赵虹 1 , 李亚楠 1 , 刘菊 1 , 袁烨 1
1 首都医科大学石景山教学医院北京市石景山医院神内二病区,北京 100043
2 北京市丰台中西医结合医院骨科,北京 100072
通讯作者 雪峰 李 Email: lxf285639@163.com
DOI: 10.3978/j.issn.2095-6959.2016.12.006
基金:
北京市石景山医院基金项目 2014-05

摘要

目的:探讨阿替普酶(alteplase,rt-PA)静脉溶栓用于发病3~4.5 h急性脑梗死患者的临床疗效及安全性。方法:将152例发病在3~4.5 h的急性脑梗死患者随机分配至观察组(n=76)和对照组(n=76),对照组采用拜阿司匹林治疗,观察组在对照组的基础上给予rt-PA静脉溶栓。观察两组临床疗效及治疗期间的出血性转化率。结果:两组治疗前美国国立卫生研究院卒中量表(national institutes of health stroke scale,NIHSS)、Barthel指数(BI)评分比较,差异无统计学意义(P>0.05),治疗后14,30,90 d观察组的NIHSS评分低于对照组,BI评分高于对照组,差异均有显著统计学意义(P<0.01);治疗后90 d观察组的改良Rankin量表(mRS)评估结果显著优于对照组(P<0.01);观察组治疗期间的出血性转化率高于对照组,但两组比较差异无统计学意义(P>0.05)。结论:rt-PA静脉溶栓治疗在3~4.5 h急性脑梗死患者中仍具有显著效果,且并未明显增加出血性转化率。


Clinical efficacy and safety of intravenous thrombolysis treated with alteplase on acute cerebral infarction within 3—4.5 h

Abstract

Objective: To investigate the clinical efficacy and safety of intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) in patients with acute cerebral infarction (3—4.5 h). Methods: 152 patients with acute cerebral infarction (3—4.5 h) were randomly assigned to the observation group (n=76) and control group (n=76). The control group was given aspirin therapy, the observation group was given rt-PA intravenous thrombolysis on the basis of the control group. Observed the clinical curative effect of the two groups and the hemorrhagic transformation rate. Results: The difference of National Institutes of Health Stroke Scale (NIHSS) and Barthel index (BI) scores were not statistically significant (P>0.05) before treatment. The difference of NIHSS and BI scores (14th day, 30th day, 90th day after treatment) of two groups were statistically significant (P<0.01); NIHSS was lower, the BI was higher compared to control group. The modified Rankin scale (mRS) (90th day) in the observation group was significantly better than the control group (P<0.01). The hemorrhagic transformation rate of the observation group was higher than that of the control group, but there was no significant difference between the two groups (P>0.05). Conclusion: rt-PA intravenous thrombolytic therapy in patients with acute cerebral infarction in 3—4.5 h still has significantly effect, and does not significantly increase the rate of hemorrhagic transformation.


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引用

引用本文: 俊英 尚, 雪峰 李, 虹 赵, 亚楠 李, 菊 刘, 烨 袁. 阿替普酶静脉溶栓治疗发病3~4.5 h急性脑梗死的疗效及安全性研究[J]. 临床与病理杂志, 2016, 36(12): 1923-1927.
Cite this article as: SHANG Junying, LI Xuefeng, ZHAO Hong, LI Yanan, LIU Ju, YUAN Ye . Clinical efficacy and safety of intravenous thrombolysis treated with alteplase on acute cerebral infarction within 3—4.5 h[J]. Journal of Clinical and Pathological Research, 2016, 36(12): 1923-1927.