重组组织型纤溶酶原激活剂静脉溶栓治疗对急性脑梗死患者血浆和肽素的影响  

Effect of rt-PA on Plasma Copeptin in Patients with Acute Cerebral Infarction

作　　者：周辉[1] 刘勇[2] 沈晓明[2] 

机构地区：[1]海南省三亚市人民医院神经内科,海南三亚572000 [2]广州中医药大学,2011级博士广东广州510405

出　　处：《中国医药指南》2012年第33期20-22,共3页Guide of China Medicine

摘　　要：目的探讨重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗急性脑梗死(ACI)的疗效及安全性,以及对血浆和肽素的影响。方法将发病<4.5h的ACI患者64例分为rt-PA组与对照组;对照组给予常规治疗,rt-PA组在常规治疗基础上给予rt-PA静脉溶栓治疗。检测64例ACI患者入院时及治疗后14d血浆和肽素水平和10例健康体检患者(正常组)空腹血浆和肽素水平。分别于治疗前及治疗后90d,采用中国脑卒中临床神经功能缺损评分量表(CSS)及Barthel指数(BI)对患者进行评定,对比两组的疗效,并评价安全性。结果入院时血浆和肽素水平比较,rt-PA组和对照组较正常组明显增高(P<0.01),rt-PA组和对照组之间差异无统计学意义(P>0.05),治疗14d后,rt-PA组和对照组血浆和肽素水平均较治疗前明显降低(P<0.01),rt-PA组降低更明显(P<0.01)。CSS评分和BI比较,治疗前rt-PA组与对照组差异无统计学意义(P>0.05),治疗后rt-PA组较对照组改善更明显,差异有统计学意义(P<0.01)。两组出血并发症发生率差异无统计学意义。结论 ACI发病4.5h内给予rt-PA静脉溶栓能显著降低血浆和肽素水平,治疗有效、安全。Objective To investigate the efficacy and safety of recombinant tissue-type plasminogen activator（rt-PA） in acute cerebral infarction（ACI）,and the effect to plasma copeptin.Methods 64 ACI patients（stroke onset within4.5h）were randomized into rt-PA and control groups.The control group were treated with conventional therapy,and the rt-PA group with additional rt-PA besides conventional therapy.The plasma copeptin level were measured in 64 ACI patients on admission and 14 days after treatment and in 10 healthy patients（normal group）.The Chinese Stroke Scale（CSS） and the Barthel Index（BI） were used to evaluate the neurological functions before and 90 days after treatment.Results On admission,the plasma copeptin level in rt-PA and control groups were significantly higher than in normal group（P0.01）,there was no significant difference between the rt-PA and control group（P0.05）,the plasma copeptin level was significantly lower 14 days after treatment in both groups（P0.01）,and it was significantly lower in rt-PA group than in control group（P0.01）.CSS scores and BI of the rt-PA group and the control group showed no significant difference before treatment（P0.05） and were significantly different after treatment（P0.01）.The bleeding complication rate was no significant different in two groups（P0.05）.Conclusion Intravenous rt-PA thrombolysis within 4.5 h from onset can significantly reduce plasma copeptin level and is effective and safe in ACI patients.

关 键 词：脑梗死 静脉溶栓 重组组织型纤溶酶原激活剂 和肽素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]