比较静脉溶栓与双抗治疗脑梗死后PLT、凝血指标、D-二聚体变化  

Comparison the changes of PLT,coagulation index and D-dimer in the treatment of dual antiplatelet with thrombolytic therapy

作　　者：连丽霞[1] 张佩兰[2] 罗玉福[3] 赵新亮[3] LIAN Lixia ZHANG Peilan LUO Yufu et al(Tianjin Medical University, Tianjin 300071 ,China)

机构地区：[1]天津医科大学,天津300070 [2]天津市环湖医院,天津300060 [3]天津市永久医院,天津300450

出　　处：《中风与神经疾病杂志》2017年第1期56-58,共3页Journal of Apoplexy and Nervous Diseases

摘　　要：目的静脉应用rt-PA(阿替普酶)和口服应用阿司匹林联合氯吡格雷治疗急性脑梗死后,了解24h内的PLT、凝血指标、D-二聚体的变化。方法收集发病在4.5 h以内的急性脑梗死患者,一组静脉应用rt-PA,另一组口服阿司匹林联合氯吡格雷,24 h内取血化验血小板计数、凝血指标、D-二聚体,比较两组差异。结果溶栓后24 h内,D-二聚体、PLT增高,Fib降低,TT、PT、APTT延长,分别与溶栓前和双抗组比较,有统计学意义。结论在治疗后24 h内阿替普酶静脉溶栓比双重抗血小板治疗更好的溶解血栓,对血栓作用更强,并且不增加继发脑出血的病死率,给急性脑梗死后选择溶栓治疗还是双抗治疗提供参考。Objective Comparison of alteplase（ rt-PA） PLT,blood coagulation index,D-dimer intravenous thrombolytic therapy and dual antiplatelet in treatment of acute cerebral infarction within 24 hours. Methods Collected incidence in 4. 5 hours of acute cerebral infarction patients and a group of intravenous RT PA,another group of aspirin combined with clopidogrel,within 24 hours from laboratory tests of blood platelet count,blood coagulation index,D-dimer and compared between the two groups differences. Results Within 24 hours after thrombolysis,PLT,D-dimer increased,PT,APTT,TT significantly increased,Fib significantly reduced,compared with before and after thrombolysis,the two groups had statistical significance. Conclusion Within 24 hours after treatment,thrombolysis effect was better in alteplase therapy than dual antiplatelet therapy,and alteplase therapy does not increase cerebral hemorrhage mortality rate,the choice of thrombolytic therapy or dual antiplatelet therapy to acute cerebral infarction remains to be cleared.

关 键 词：脑梗死 静脉溶栓 双重抗血小板 血小板计数 凝血项 D-二聚体 

分 类 号：R743[医药卫生—神经病学与精神病学]