重组组织型纤溶酶原激活剂静脉溶栓治疗急性脑梗死  

Clinical study on rt-PA intravenous thrombolysis for patients with acute cerebral infarction

作　　者：杨云[1] 王智明[1] 陈玉兰[1] 李旭东[1] 霍志成[1] 

机构地区：[1]东莞市太平人民医院心脑血管内科,广东东莞523900

出　　处：《中国基层医药》2005年第7期777-779,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的观察重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗早期急性脑梗死的疗效和安全性.方法急性脑梗死44例(发病时间＜6 h)随机分为溶栓组21例,对照组23例.溶栓组用rt-PA 0.9 mg/kg,先于2 min内静脉注射rt-PA 8 mg,再将余量于1 h内静脉泵输入;对照组不使用rt-PA.两组其他治疗均相同.评定指标包括:治疗前,治疗后6 h、24 h、7 d、30 d、90 d临床神经功能缺损程度评分(CSS);治疗前,治疗后90 d日常生活活动量表(Barthel指数);30 d脑出血率、病死率.结果溶栓组溶栓后6 h、24 h、7 d、30d、90 d CSS为15.38、13.24、9.30、7.40、5.00;90 d总显效率为76.19%;90 d Barthel指数评分为95～100分者占57.14%;脑出血率为9.52%;病死率为4.76%.对照组治疗后6 h、24 h、7 d、30 d、90 d CSS为20.65、18.78、14.90、13.00、11.95;90 d总显效率为30.43%;90 d Barthel指数评分为95～100分者占21.74%;无颅内出血;病死率为8.69%.溶栓组CSS明显低于对照组(P＜0.01),总显效率明显高于对照组(P＜0.01).结论急性脑梗死早期应用rt-PA静脉溶栓治疗安全有效.Objective To investigate the efficacy and safety of rt-PA（recombinant tissue plasminogen activator） intravenous thrombolysis for patients with acute cerebral infarction. Methods 44 cases of acute cerebral infarction within 6 hours from the onset of stroke were divided into two groups：intravenous thrombolysis group（21 cases） and control group（23 cases）. Actilyse（rt-PA） was administrated in a dose of 0.9mg/kg. 8mg was injected intravenously in 2 minutes,and the rest was infused in 1 hour for intravenous thrombolysis group. The control group received only routine treatment. The evaluatation index included scoring clinical stroke scale（CSS） before treatment ;24 hours, 7 days, 30 days and 90 days after treatment, barthel index（BI）, mortality and side effects before treatment and 90 days after treatment. Results Scoring of CSS 6 hours,24 hours, 7 days, 30 days and 90 days after treatment were 15.38,13.24,9.30,7.40,5.00 in intravenous thrombolysis group, and 20.65,18.78,14.90,13.00,11.95 in control group. High score of BI（95-100） at 90 days after treatment were 57.14% in intravenous thrombolysis group and 21.74% in control group. The efficacy rate and mortality rate were 76.19%, 4.76% in intravenous thrombolysis group,and 30.43 %, 8.69% in control group. All the data show significant differences between two groups（P〈0.01）. Conclusion Early application of rt-PA intravenous thrombolysis is effective and safe for patients with acute cerebral infarction.

关 键 词：重组组织型纤溶酶原激活剂 静脉溶栓 治疗 急性脑梗死 

分 类 号：R743.33[医药卫生—神经病学与精神病学]