轻型急性缺血性卒中溶栓治疗的疗效及安全性研究  

Efficacy and Safety of Thrombolysis in people with Acute Mild Ischemic Stroke

作　　者：施国文[1] 林岩[1] 金海峰[1] 俞羚[1] 杨立刚[1] 陈莺[1] 潘元美[1] 吴恒趋[1] 戴若莲[1] 管阳太 SHI Guowen;LIN Yan;JIN Haifeng(Department of Nuerology,Renji Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院神经内科,上海200127 [2]不详

出　　处：《中风与神经疾病杂志》2018年第7期599-602,共4页Journal of Apoplexy and Nervous Diseases

摘　　要：目的研究轻型急性缺血性卒中溶栓治疗的疗效及安全性。方法回顾性研究2015年5月~2017年5月在仁济医院接受溶栓治疗的急性缺血性脑卒中患者资料共计105例患者,其中56例患者基线NIHSS≤5,为轻型卒中组。其余49例患者基线NIHSS>5,为非轻型卒中组。比较两组基线资料,溶栓后NIHSS降分率,并发症发生率,死亡率,14 d功能恢复良好率(MRS<3分)的差异。结果基线资料比较了两组性别比、年龄、溶栓DNT时间、高血压,糖尿病,TIA,既往卒中史发生率,没有明显差异。非轻型卒中组有心脏疾病史的比例明显高于较轻型卒中组,有统计学差异。(23(46.9%)vs 7(12.5%),P<0.01)。非轻型卒中组心源性卒中的比例明显高于较轻型卒中组,有统计学差异。[15(30.6%)vs 3(35.4%).,P<0.01]。非轻型卒中组并发症发生率较轻型卒中组并发症明显增高,有统计学差异[11(22.4%)vs.2(3.6%),P<0.01]。非轻型卒中组发生溶栓后颅内出血5例,牙龈出血1例,而轻型卒中组没有出血发生。非轻型卒中组有6例死亡,轻型卒中组无死亡病例,两组有统计学差异(6(12.2%)vs.0(0%),P<0.01)。两组在溶栓治疗后24 h、14 d NIHSS降分率相似,没有统计学差异。溶栓后14 d MRS<3分患者,轻型卒中组为(76.8%)优于非轻型卒中组(59.2%),但是没有统计学差异。结论轻型急性缺血性卒中接受静脉溶栓治疗与非轻型急性缺血性卒中的疗效相似,且并发症发生率、死亡率低,未发现颅内出血,安全性好。Objective To study the efficacy and safety of thrombolysis in mild acute ischemic stroke. Methods Retrospective Study. A total of 105 acute stroke patients were enrolled in the study who received thrombolysis in Renji Hospital from May 2015 to May 2017.Fifty-six patients with baseline NIHSS≤5 were classified into mild stroke group. The other 49 patients with baseline NIHSS〉5 were non-mild stroke group. The differences in the rate of reduction of NIHSS,the incidence of complications,the rate of death and the rate of recovery of 14 days （MRS〈3 points） were compared between the two groups. Results Baseline data were compared between the two groups in terms of percentages of gender,age,DNT time,hypertension,diabetes,TIA,previous stroke history. There was no significant difference between two groups. In the non-mild stroke group,the history of heart disease was significantly higher than the mild stroke group （23（46.9%）vs 7（12.5%）,P〈0.01）. Compared with mild stroke group,cardiogenic stroke was also significantly higher in the non-mild stroke group. （15 （30.6%） vs. 3 （35.4%）, P 〈 0.01 ）. The incidence of complication in the non-mild stroke group was significantly higher than the mild stroke group （11（22.4%）,2（3.6%） P〈0.01）. In the non-mild stroke group,there were five cases of intracranial hemorrhage after thrombolysis,one case of gingival bleeding,and no bleeding in the mild stroke group. There were 6 cases of death in the non-mild stroke group and no death in the mild stroke group. There was significant difference between the two groups （6（12.2%）vs. 0（0%） P〈0.01）. The rates of reduction of NIHSS were similar in the two groups after 24 hours of thrombolysis,with no statistically significant difference between groups. In patients with MRS〈3,mild stroke group （76.8%） was superior to non-mild stroke group （59.2%） 14 days post thrombolysis,but there was not statistically significant. Conclusion The efficacy of thrombolysis in mild acute isch

关 键 词：轻型卒中 溶栓 疗效 并发症 

分 类 号：R743.3[医药卫生—神经病学与精神病学]