重组组织型纤溶酶原激活剂超早期静脉溶栓治疗急性脑梗死的疗效观察  

Efficacy of thrombolysis by intravenous recombinant tissue plasminogen activator in hyperacute cerebral infarction

作　　者：李浩军[1] 刘鸣[1] 沈飒[1] 刘红[1] 潘曙明[1] 

机构地区：[1]上海市交通大学医学院附属新华医院急救中心,上海200092

出　　处：《中国新药杂志》2010年第11期953-955,共3页Chinese Journal of New Drugs

摘　　要：目的:探讨重组组织型纤溶酶原激活剂(rt-PA)超早期静脉溶栓治疗急性脑梗死(ACI)的疗效。方法:对60例发病<3 h的ACI患者随机分为rt-PA组和对照组,每组各30例。rt-PA组给予rt-PA总量0.9 mg.kg-1,最大剂量50 mg进行静脉溶栓治疗。对照组应用达肝素钠5 000 IU皮下注射,bid,共7 d。治疗前及治疗后2 h,24 h,14 d及3个月时分别采用美国国立卫生院卒中量表(NIHSS)评分,以及溶栓后3个月日常生活能力Barthal指数(BI)评分,继发性颅内出血(sICH)率及3个月时的死亡率评价其疗效及安全性。结果:rt-PA组较对照组在各时间点(2 h,24 h,14 d,3个月)的NIHSS评分均有改善(P<0.05);rt-PA组较对照组在3个月后的BI指数评分有显著改善(P<0.01)。而两组在sICH率及3个月时的死亡率无明显差异(P>0.05)。结论:ACI发病3 h内给予rt-PA静脉溶栓治疗安全,有效。Objective： To evaluate the efficacy of thrombolysis by intravenous rt-PA in hyperacute cerebral infarction（ACI）.Methods： ACI patients（n=60） within 3 h after the onset of stroke were enrolled in the trial.They were randomly divided into rt-PA（n=30） and control groups（n=30）.rt-PA was administered in a dose of 0.9 mg·kg-1（maximum dose 50 mg） intravenously.Dalteparin（5 000 IU） was subcutaneously injected,twice a day for 7 days,in control group.The NIHSS scores were evaluated before and 2 h,24 h,14 d,3 months after treatments.At 3 months,BI scale,the incidence of secondary intracranial hemorrhage（sICH） and the mortality were calculated to assess the efficacy and safety.Results： The NIHSS scores at each time point and BI scales at 3 months were significantly improved in rt-PA group as compared with control group（P0.05 and 0.01）.The incidence of sICH and the mortality at 3 months were not significantly different between the two groups（P0.05）.Conclusion： Administration of rt-PA within 3 h of onset is safe and effective in ACI patients.

关 键 词：静脉内溶栓 重组组织型纤溶酶原激活剂 脑梗死 

分 类 号：R743.3[医药卫生—神经病学与精神病学]