前-后循环急性脑梗死静脉溶栓疗效比较及安全评价  

Efficiency and safety of rt-PA intravenous thrombolysis therapy for anterior-posterior circulation acute cerebral stroke

作　　者：郭翠萍[1] 白青科[1] 赵晓晖[1] 陈娟[1] 沈健[1] 赵振国[1] 

机构地区：[1]上海市浦东新区人民医院神经内科,上海201200

出　　处：《脑与神经疾病杂志》2014年第5期330-332,共3页Journal of Brain and Nervous Diseases

基　　金：上海市浦东新区卫生系统重点学科建设资助(PWZx2014-15);上海市卫计委基金(20134179);上海市浦东新区科技发展基金(PKJ2013-Y27);上海市浦东新区卫生系统领先人才培养基金(PWR12010-02);上海市浦东新区人民医院重点学科群基金(PRxkq2013-03)

摘　　要：目的探讨前-后循环急性脑梗死静脉溶栓疗效差异及安全性评价。方法对前-后循环急性脑梗死120例,其中前循环64例及后循环56例急性脑梗死进行rt-PA静脉溶栓治疗,比较两组间神经功能恢复情况;并通过Logistic回归分析影响急性脑梗死rt-PA静脉溶栓后出血风险的独立危险因素。结果两组患者经溶栓治疗后24h、2w神经功能较溶栓治疗前均有明显恢复(P<0.01),两组之间溶栓治疗后24h神经功能恢复差异无统计学意义,但两组之间溶栓治疗后2w神经功能恢复差异有统计学意义(P<0.05);Logistic回归分析表明高血压病、心房纤颤、糖尿病及吸烟增加rt-PA静脉溶栓出血风险。结论在急性脑梗死的rt-PA静脉溶栓治疗中,前循环疗效优于后循环,且高血压病、心房纤颤、糖尿病及吸烟影响rt-PA静脉溶栓疗效,有增加出血风险可能,从而影响患者日后生活质量。Objective To study efficiency and safety of rt-PA intravenous thrombolysis therapy for anteriorposterior circulation acute cerebral stroke.Methods rt-PA intravenous thrombolysis therapy for patients with anterior-posterior circulation acute cerebral stroke in 120 cases,including 64 cases of anterior circulation and 56cases posterior circulation.The comparison between two groups of nerve function recovery,and through the Logistic regression analysis of the influence on rt-PA intravenous thrombolysis therapy in acute cerebral stroke risk of bleeding.Results Neural function of two groups has obvious recovery between intravenous thrombolytic therapy before and after 24h,2W.24h neural function recovery without significant differences between two groups,but the 2 weeks neural function recovery after thrombolytic therapy with significant difference （P＜0.05）,Logistic regression analysis showed that hypertension,atrial fibrillation,diabetes and smoking increased rt-PA intravenous thrombolysis bleeding risk.Conclusion In the rt-PA intravenous thrombolytic therapy in acute cerebral stroke in the anterior circulation,curative effect is better than that of posterior circulation.And hypertension,atrial fibrillation,diabetes and smoking affects rt-PA intravenous thrombolysis,increasing the risk of bleeding,thus affecting the quality of life of patients after.

关 键 词：脑梗死 重组组织型纤溶酶原激活剂 静脉溶栓 前-后循环 

分 类 号：R743.32[医药卫生—神经病学与精神病学]