不同剂量瑞替普酶治疗急性脑梗死的研究  

Different doses of reteplase in treatment of acute cerebral infarction

作　　者：邓可[1] 吴晓球[1] 张咏[1] 

机构地区：[1]湖南师范大学附属岳阳医院岳阳市二人民医院神经内科,湖南岳阳414000

出　　处：《临床荟萃》2017年第10期841-844,共4页Clinical Focus

基　　金：湖南省科技计划项目(2013FJ3142);湖南省卫生厅项目(C2013-066)

摘　　要：目的探讨急性脑梗死患者使用不同剂量瑞替普酶(reteplase,rPA)治疗的安全性与有效性。方法采用病例对照研究,对符合中国脑血管防治指南规定的溶栓条件、发病时间在6小时内的急性脑梗死患者,使用不同剂量rPA(0.9mg/kg或0.6mg/kg)静脉溶栓治疗。比较患者入院时NIHSS评分、溶栓24小时NIHSS评分、3个月后病死率、症状性颅内出血(sIcH)发生率等。结果 (1)两种不同剂量组在入院时的NIHSS评分、发病距溶栓用药时间、溶栓后12小时的凝血功能,差异无统计学意义(P>0.05)。(2)两种不同剂量组溶栓前后NIHSS评分均有明显降低,差异有统计学意义(P<0.05)。(3)两种不同剂量组sIcH发生率、溶栓后24小时NIHSS评分及3个月内病死率,差异无统计学意义(P>0.05)。结论两种不同剂量(0.9mg/kg或0.6mg/kg)rPA对急性脑梗死溶栓治疗均有效,两种不同剂量组间sIcH的发生无差异。Objective To study the efficacy and safety of different dose reteplase therapy in patients with acute cerebral infarction. Methods The study was a case-control study. In accordance with the thrombolytic conditions prescribed by the Chinese guidelines for cerebrovascular prevention and treatment, patients with acute cerebral infarction within 6 hours of the onset time were treated with different doses of rPA （0.9 mg/kg or 0.6mg/kg） intravenous thrombolytic therapy. NIHSS-baseline, 24 hours after thrombolysis NIHSS, the mortality after three months and the incidence of symptomatic intracranial hemorrhage（slcH） were compared. Results ① NIHSS score, time of onset, time of thrombolytic therapy and coagulation function after 12 hours were not statistically significant （ P 0.05）. ② NIHSS and 24 hours after thrombolysis NIHSS in different doses of thrombolysis were significantly reduced （P 〈0.05）. ③The incidence of sIcH in two different dosage groups, the mortality rate within 24 hours after thrombolysis and NIHSS and three months after thrombolysis were not statistically significant （ P 〉0.05）. Conclusion Different doses of rPA （0.9 mg/kg or 0.6 mg/kg） are both effective in thrombolytic therapy for acute cerebral infarction. Furthermore, there was no statistical difference between different doses in sIcH.

关 键 词：脑梗死 瑞替普酶 颅内出血 低剂量 

分 类 号：R743.33[医药卫生—神经病学与精神病学]