阿替普酶联合依达拉奉治疗急缺血性卒中患者的临床研究  

Clinical Study of the Effect of Edaravone Combined with Alteplase on Acute Cerebral Infarction

作　　者：朱立勋 陆学胜 耿瑞慧[2] 李克良 

机构地区：[1]上海同仁医院神经内科,上海200336 [2]武警8640部队医院内一科,河北定州073000

出　　处：《中国医药指南》2015年第16期36-37,共2页Guide of China Medicine

摘　　要：目的：评价重组组织型纤溶酶原激活剂（rt-PA）联合依达拉奉静脉治疗对发病4.5 h内急性脑梗死的疗效和安全性。方法将我院2010年~2014年神经内科收治的80例急性脑梗死患者分为试验组及对照组，其中试验组32例、单用rt-PA组48例。2组患者均采用阿替普酶抗凝治疗，观察组患者加用依达拉奉治疗。评价2组治疗后28 d的疗效，包括神经功能缺损评分（NIHSS），同时观察再脑出血发生率及病死率。结果2组患者28 d有效率差异有统计学意义（P＜0.05）；2组脑出血（症状性脑出血＋非症状性脑出血）发生率分别为12.5%、14.5%差异无统计学意义；2组病死率分别为0、14.5%，比较差异有统计学意义（P＜0.05）。结论依达拉奉联合阿替普酶治疗急性脑梗死，可改善患者神经功能，效果满意，该治疗方法是安全有效的，值得推广应用。Objective To evaluate the eifcacy and safety of combined therapy of recombinant tissue plasminogen activator（rt-PA） and edaravon in patients with acute cerebral infarction within 4.5 hours of onset. Methods Eighty pationts with acute cerebral infarction in our hospital in 2010-2014 damitted into observation group ang control groups：combined edaravon therapy group which included 32 patients,patients,the rt-PA group included 48 patients,two groups pationts were treated with alteplase antcoagulant therapy, the observation group were added with edaravone treatment. The outcome scores were evaluated according to the National Institute of Heath Stroke Scale（NIHSS） before treatment and 28 days after symptom onset,and the hemorrhagic transformation and death as the safety indicators were evaluated. Result There were signiifcant diferences in eifcacy outcome rate between 2 groups at 28 days（P〈0.05）.The incidence of mortalitin in each group was 0, 14.5%respectively and there were signiifcant diferences between 2 groups （P〈0.05）.There were no signiifcant diferences between 2 groups in the incidence of cerebral hemorrhage （symptomatic and non-symptomatic intracerebra｜hemorrhage） in each group（P〉0.05）. Conclusion Edaravone combined alteplase treatmeng of acute cerebral infarction can improve neurological function in patients with satisfactory results, so the combined therapy is safe and efective and it is worth in clinical practice.

关 键 词：脑梗死 重组组织型纤溶酶原激活剂 依达拉奉 

分 类 号：R743.33[医药卫生—神经病学与精神病学]