阿替普酶静脉溶栓治疗发病3～4.5h急性脑梗死的疗效及安全性研究  

Clinical efficacy and safety of intravenous thrombolysis treated with alteplase on acute cerebral infarction within 3—4.5 h

作　　者：尚俊英[1] 李雪峰 赵虹[1] 李亚楠[1] 刘菊[1] 袁烨[1] 

机构地区：[1]首都医科大学石景山教学医院北京市石景山医院神内二病区,北京100043 [2]北京市丰台中西医结合医院骨科,北京100072

出　　处：《临床与病理杂志》2016年第12期1923-1927,共5页Journal of Clinical and Pathological Research

基　　金：北京市石景山医院基金(2014-05)~~

摘　　要：目的：探讨阿替普酶（alteplase，rt-PA）静脉溶栓用于发病3-4.5 h急性脑梗死患者的临床疗效及安全性。方法：将152例发病在3-4.5 h的急性脑梗死患者随机分配至观察组（n=76）和对照组（n=76），对照组采用拜阿司匹林治疗，观察组在对照组的基础上给予r t-PA静脉溶栓。观察两组临床疗效及治疗期间的出血性转化率。结果：两组治疗前美国国立卫生研究院卒中量表（national institutes of health stroke scale，NIHSS）、Barthel指数（BI）评分比较，差异无统计学意义（P〉0.05），治疗后14，30，90 d观察组的NIHSS评分低于对照组，BI评分高于对照组，差异均有显著统计学意义（P〈0.01）；治疗后90 d观察组的改良Rankin量表（mRS）评估结果显著优于对照组（P〈0.01）；观察组治疗期间的出血性转化率高于对照组，但两组比较差异无统计学意义（P〉0.05）。结论：rt-PA静脉溶栓治疗在3-4.5 h急性脑梗死患者中仍具有显著效果，且并未明显增加出血性转化率。Objective： To investigate the clinical efficacy and safety of intravenous thrombolysis with recombinant tissue plasminogen activator （rt-PA） in patients with acute cerebral infarction （3—4.5 h）.Methods： 152 patients with acute cerebral infarction （3—4.5 h） were randomly assigned to the observation group （n=76） and control group （n=76）. hTe control group was given aspirin therapy, the observation group was given rt-PA intravenous thrombolysis on the basis of the control group. Observed the clinical curative effect of the two groups and the hemorrhagic transformation rate.Results： hTe difference of National Institutes of Health Stroke Scale （NIHSS） and Barthel index （BI） scores were not statistically significant （P〉0.05） before treatment. The difference of NIHSS and BI scores （14th day, 30th day, 90th day atfer treatment） of two groups were statistically signiifcant （P〈0.01）; NIHSS was lower, the BI was higher compared to control group. hTe modiifed Rankin scale （mRS） （90th day） in the observation group was signiifcantly better than the control group （P〈0.01）. hTe hemorrhagic transformation rate of the observation group was higher than that of the control group, but there was no signiifcant difference between the two groups （P〉0.05）.Conclusion： rt-PA intravenous thrombolytic therapy in patients with acute cerebral infarction in 3—4.5 h still has signiifcantly effect, and does not signiifcantly increase the rate of hemorrhagic transformation.

关 键 词：急性脑梗死 阿替普酶 静脉溶栓 

分 类 号：R743.33[医药卫生—神经病学与精神病学]