多量表对急性脑梗死静脉溶栓的疗效评价  

Therapeutic Evaluation of Intravenous Thrombolysis in Acute Cerebral Infarction by Multi Scales

作　　者：金雪红[1] 李霞[1] 姚潇涵 裴少芳[1] 

机构地区：[1]南京医科大学附属苏州市市立医院北区神经内科,江苏南京215000

出　　处：《吉林医学》2016年第2期332-335,共4页Jilin Medical Journal

摘　　要：目的:通过不同的量表来评价重组组织型纤溶酶原激活剂(rt-PA)治疗急性脑梗死的疗效。方法:符合入选标准的病例66例,其中治疗组30例,对照组36例,治疗组给予正规rt-PA静脉溶栓治疗,对照组给予口服抗血小板聚集药物治疗。全部患者治疗前后多个时间点进行美国国立卫生研究院卒中量表评分(NIHSS)、中国卒中量表评分(CSS)、欧洲卒中量表评分(ESS),并通过Barthel指数(BI)和Rankin分级(mRS)来比较两组第90天时的预后良好率。结果:治疗前及治疗后第7天三种评分方法在治疗组和对照组间差异均无统计学意义(P>0.05);在治疗后第30天时治疗组NIHSS评分要显著低于对照组(P<0.05),而CSS、ESS评分治疗组和对照组有差异无统计学意义(P>0.05);第90天时,三种量表评分均提示治疗组要显著优于对照组,差异有统计学意义(NIHSS:P<0.01,CSS和ESS:P<0.05)。90天时预后良好率BI两组间差异无统计学意义(P>0.05),mRS治疗组显著高于对照组,差异有统计学意义(P<0.05)。结论:4.5小时内rt-PA静脉溶栓均可改善急性脑梗死患者的预后,NIHSS和BI评分可能更敏感。Objective Using multi scales to evaluate the efficacy of intravenous thrombolysis by rt- PA in patients with cerebral infarction. Method 66 patients who met inclusion criteria were devided into two groups,there were 30 cases in treatment group and 36 cases in control group. The treatment group was given intravenous thrombolysis,while the control group was given antiplatelet therapy. All the patients were scored by NIHSS、CSS、ESS before treatment and multiple time points after treatment,also,the good prognosis rate was compared after 90 days by mRS and BI in two groups. Results There were no significant difference between the two groups before treatment,and also within a week of treatment（ P〉0. 05）. 30 days after treatment,the NIHSS of treatment group was significantly better than control group（ P〈0. 05）,While the CSS、ESS were not statistically significant（ P〉0. 05）. 90 days after treatment,the NIHSS、ESS、CSS of treatment group were all significantly better than that of control group（ NIHSS： P 0. 01,CSS and ESS： P〈0. 05）. 90 days after treatment,there were no significant difference between the two groups about the good prognosis rate evaluated by BI（ P〉0. 05）. But there were significant difference between the two groups about the good prognosis rate evaluated by mRS（ P〈0. 05）. Conclusion Intravenous thrombolysis by rt- PA within 4. 5 hours can improve prognosis of patients with cerebral infarction. Maybe,NIHSS and BI are more sensitive.

关 键 词：脑梗死 静脉溶栓 量表 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]