阿替普酶静脉溶栓在不同时间窗急性缺血性脑卒中的疗效及安全性研究  

Safety and efficacy of intravenous thrombolysis by alteplase in acute cerebral ischemic stroke within different time windows

作　　者：宋文明[1] 林智君[2] 刘菊花[1] 黄勇[1] 

机构地区：[1]廉江市人民医院神经内科,广东524400 [2]广东医学院附属医院神经内科,湛江524001

出　　处：《齐齐哈尔医学院学报》2016年第14期1792-1794,共3页Journal of Qiqihar Medical University

摘　　要：目的探讨阿替普酶静脉溶栓在不同时间窗急性缺血性脑卒中的疗效及安全性。方法将来自2012年12月至2015年9月的92例急性缺血性脑卒中患者按照时间窗不同分为三组：A组为发病3 h内溶栓组（27例）、B组为发病3~4.5 h溶栓组（31例）和C组为发病4.5~6 h溶栓组（34例）。三组均采用阿替普酶静脉溶栓。统计三组的NIHSS评分,疗效和不良事件,采用pearson卡方检验,yates卡方检验和t检验分析相关数据。结果 A组溶栓后6 h、溶栓后24 h、溶栓后14天和溶栓后3个月的NIHSS评分均明显低于溶栓前和C组（P〈0.05）;B组和C组溶栓后6 h溶栓后14天和溶栓后3个月的NIHSS评分均明显低于溶栓前（P〈0.05）;A组的总有效率明显高于C组（P〈0.05）;三组的不良事件发生率差异无统计学意义（P〉0.05）。结论阿替普酶静脉溶栓在急性缺血性脑卒中发生6 h内疗效明确和安全性极佳,而且溶栓治疗越早,其疗效越佳。Objective To investigate the safety and efficacy of intravenous thrombolysis by alteplase in the acute cerebral ischemic stroke within different time windows. Methods The acute cerebral ischemic stroke patients who received and cured from December 2012 to September 2015 were divided into three groups according to the time window ： the A group was time window 3h（ 27 cases）,the B group was time window 3 ~ 4. 5h（ 31cases）,and the C group was time window 4. 5 ~ 6h（ 34 cases）. The patients were all treated with intravenous thrombolysis by alteplase in the three groups. The NIHSS score,curative effect and adverse events in the three groups were statistical. Pearson Chi-square test,Yates Chi-square test and t test were used to analyze the data.Results The NIHSS score of 6 hours after thrombolysis,24 hours after thrombolysis,14 days after thrombolysis and 3 months after thrombolysis in the A group were significantly lower than the C group and before thrombolysis（ P〈0. 05）; the NIHSS score of 14 days after thrombolysis and 3 months after thrombolysis in the B group and C group were Significantly lower than before thrombolysis（ P〈0. 05）; the total effective rate in the A group were obvious higher than the C group（ P〈0. 05）; the difference of adverse events incidence rate in the three groups were not statistically significant（ P〈0. 05）. Conclusions The curative effect is clear-cut and excellently safe for intravenous thrombolysis by alteplase in the acute cerebral ischemic stroke within 6h time window,and the earlier is thrombolytic therapy,the curative effect is better.

关 键 词：脑卒中 阿替普酶 溶栓 时间窗 疗效 安全性 

分 类 号：R743.31[医药卫生—神经病学与精神病学]