急性脑梗死阿替普酶静脉溶栓治疗的临床分析  

The Clinical Research of Intravenous Thrombolysis with Alteplase in Patients with Acute Ischemic Stroke

作　　者：丁红[1] 刘梅[1] 刘庆萍[1] 许正强[1] 吴岩峰[1] 

机构地区：[1]南京医科大学第二附属医院神经内科,江苏南京210003

出　　处：《中国医药指南》2013年第36期321-322,共2页Guide of China Medicine

摘　　要：目的评价急性脑梗死(Acute cerebral infarction,ACI)患者应用阿替普酶静脉溶栓治疗的有效性与安全性。方法回顾分析2010年5月至2013年5月78例ACI溶栓治疗的患者临床资料,并选取同期未予溶栓治疗的ACI患者80例为对照组,应用美国国立卫生研究院卒中量表(NHISS评分)和改良Rankin量表(mRS评分)评价两组的神经功能改善程度和近期预后。结果溶栓组治疗后24h NIHSS评分(7.68±4.62),mRS评分(3.28±0.41),治疗后7d的NIHSS评分(5.25±4.43),mRS评分(1.11±0.62),两组相比差异具有统计学意义(P<0.01)。溶栓组患者齿龈出血58例(74%),7d无症状性出血性转化14例(18%),症状性颅内血肿3例(4%),死亡4例(5%)。非溶栓组齿龈出血2例(3%),7d无症状性出血性转化5例(6%),症状性颅内血肿2例(3%),死亡3例(4%)。结论在ACI治疗时间窗内,阿替普酶静脉溶栓治疗,可以减轻患者的神经功能障碍评分,不增加病死率,有效安全。Objective To explore the efficacy and safety of intravenous thrombolysis with alteplase patients with acute ischemic stroke. Methods Clinical data of 78 patients with acute ischemic stroke （AIS） receiving thrombolytic therapy with alteplase and 80 AIS patients without receiving thrombolytic therapy were retrospectively analyzed.The U.S. National Institutes of Health Stroke Scale （NHISS） and modified Rankin Scale （mRS） were used to identify the extent of neurological function improvement and prognosis of patients at 24h and 7 days after thrombolysis. Results In the group with intravenous thrombolysis, the significant difference in NIHSS was found between 24th hour and 7th day （7.69±4.63） vs （5.25±4.43）, P〈0.05, but in the control group, the decreased NII-ISS scores and mRS scores （1.11±0.62） vs （3.22±0.80） both shown significant differences between intravenous thrombolysis group and controls. Among the intravenous thrombolysis group, there were 58 （74%） bleeding gums, 14 （18%） hemorrhagic transformation, 3 （4%） symptomatic intraeerebral hemorrhage, and 4 （5%） patients died. In the control group, 2 （3%） had bleeding gums, 5 （6%） intracerebral hemorrhage, 2 （3%） symptomatic intracerebral hemorrhage, and 3 （4%） patients died. Conclusion This study suggests that intravenous rtPA treatment was safe and effective in patients withAIS.

关 键 词：急性脑梗死 阿替普酶 静脉溶栓治疗 神经功能障碍评分 

分 类 号：R743.33[医药卫生—神经病学与精神病学]