急性脑梗死合并2型糖尿病患者超早期rt-PA静脉溶栓的效果分析  

Clinical analysis of ultra-early intravenous thrombolysis with rt-PA in treatment of acute cerebral infarction patients with type 2 diabetes

作　　者：于海龙[1] 李军[1] 徐耀[1] 吴健[1] 石金铃[1] 俞龙[1] 

机构地区：[1]江苏省苏北人民医院,江苏扬州225001

出　　处：《实用临床医药杂志》2014年第21期20-22,共3页Journal of Clinical Medicine in Practice

摘　　要：目的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合并2型糖尿病患者的疗效。方法回顾性分析70例急性脑梗死合并2型糖尿病患者的临床资料,其中rt-PA静脉溶栓组31例,单纯治疗组39例。对患者行NIHSS评分,改良Rankin(MRS)评分及Barthel指数评估早期及晚期预后。结果静脉溶栓组24 h时NIHSS评分较单纯治疗组低(P<0.05);静脉溶栓组7 d时NIHSS评分与单纯治疗组无明显差异(P>0.05);静脉溶栓组90 d时MRS评分显示预后良好的患者较单纯治疗组多(P<0.05);静脉溶栓组90 d时Barthel指数较单纯治疗组升高(P<0.05)。静脉溶栓组出血事件较单纯治疗组高(P<0.05);但静脉溶栓组症状性脑出血与单纯治疗组相比无显著差异(P>0.05)。结论经rt-PA静脉溶栓治疗急性脑梗死合并2型糖尿病患者的总体疗效优于传统单纯综合治疗,但仍需注意静脉溶栓后出血性事件的发生。Objective To explore the efficacy of thrombolytic therapy with intravenous rtPA in treatment of acute cerebral infarction patients with type 2 diabetes. Methods Clinical materials of 70 acute cerebral infarction patients with type 2 diabetes were analyzed retrospectively, including 31 cases of patients with intravenous thrombolysis with rt-PA and 39 cases of patients with simple integrated therapy. Prognosis was evaluated by N [HSS score, MRS score and Barthal. Resuits The 24 hours NIHSS score of intravenous thrombolysis group was lower than the treatment group （P 〈 0.05）. There was no significant difference （P 〉 0.05） between two groups in the 7 days NIHSS score. 90 days MRS score of intravenous thrombolysis group was lower than the treatment group （P 〈 0.05）, and 90 days Barthal index increased in intravenous thrombolysis group. The bleeding events of thrombolytic therapy group was greater than treatment group （ P 〈 0.05）. To the symptomatic intra-cerebral hemorrhage, there was no significant difference between two groups （P 〉0.05）. Conclusion The overall effect of intravenous thrombolytic with rt-PA for acute cerebral infarction patients with type 2 diabetes is superior to the simple basic treatment, but it still need to pay strict attention on the occurrence of hemorrhagic events after intravenous thrombolysls.

关 键 词：急性脑梗死 2型糖尿病 组织型纤溶酶原复合物 静脉溶栓 

分 类 号：R587.1[医药卫生—内分泌]