急性缺血性脑卒中rt-PA动静脉联合溶栓的临床研究  

Clinical Study of Combined Arteriovenous Thrombolysis with rt-PA in Acute Ischemic Stroke

作　　者：潘成德[1] 唐明山[1] 邹耀兵 肖静[1] 江思德[1] 陶永 PAN Chengde;TANG Mingshan;ZOU Yaobing(People＇s Hospital of Chongqing Banan District,Chongqing401320,China)

机构地区：[1]重庆市巴南区人民医院,重庆401320

出　　处：《中外医学研究》2018年第17期1-3,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：重庆市卫生局2012年医学科研计划项目(项目编号:2012-2-423)

摘　　要：目的:探讨rt-PA在急性缺血性脑卒中动静脉联合溶栓中的临床效果。方法:选择2015年2月-2016年7月58例急性缺血性脑卒中患者分组。根据患者采取的溶栓方式分为动静脉溶栓组29例和对照组(静脉溶栓组)29例。对照组采用静脉溶栓治疗,用0.9 mg/kg rt-PA,1 min内给予负荷量10%,后1 h内给予静脉泵入,动静脉溶栓组则在入院后给予0.6 mg/kg rt-PA,1 min内给予负荷量10%,后30 min内给予静脉泵入,并给予超选择性动脉溶栓rt-PA,剂量0.3 mg/kg,1 h内给予动脉泵入。比较两组急性缺血性脑卒中预后情况;症状性脑出血发生率,出血转化率;干预前后患者神经功能缺损水平、生活活动能力评分、生存质量状况;干预前后患者超敏C反应蛋白、血小板聚集情况、内皮素-1水平。结果:动静脉溶栓组急性缺血性脑卒中预后总有效率优于对照组(P<0.05);动静脉溶栓组症状性脑出血发生率、出血转化率低于对照组(P<0.05);干预前两组神经功能缺损水平、生活活动能力评分、生存质量状况相近(P>0.05);干预后动静脉溶栓组神经功能缺损水平、生活活动能力评分、生存质量状况优于对照组(P<0.05)。干预前两组超敏C反应蛋白、血小板聚集情况、内皮素-1水平相近(P>0.05);干预后动静脉溶栓组超敏C反应蛋白、血小板聚集情况、内皮素-1水平优于对照组(P<0.05)。结论:rt-PA在急性缺血性脑卒中动静脉联合溶栓中的临床效果确切,可促进患者预后改善和临床生化指标改善,促进其神经功能恢复,提高患者生活活动能力和生存质量,值得推广应用。Objective： To study the clinical effect of rt-PA joint arteriovenous thrombolysis in acute cerebral ischemic stroke.Method ： From February 2015 to July 2016, 58 patients with acute cerebral ischelnic stroke were divided into two groups.According to the throlnbolysis method adopted by the patients, they were divided into two groups, the arteriovenous thrombolysis group was 29 cases and the control group（intravenous thrombolysis group） was 29 cases.The control group by intravenous thrombolysis treatment, with 0.9 mg/kg rt-PA, 1 minutes to load 10%, within the first hour after given intravenous pumping, the arteriovenous thrombolysis group was given 0.6 mg/kg rt-PA, 1 minute to load 10%, 30 minutes after given intravenous pumping, and super selective arterial thrombolysis rt-PA, dose of 0.3 mg/kg, 1 hour to pump into the artery.Two groups of acute ischelnic stroke prognosis, the incidence of symptomatic cerebral hemorrhage, bleeding conversion, patients with nerve function defect levels before and after the intervention, the condition of life activities ability score, quality of survival, before and after the intervention in patients with allergic C-reactive protein, platelet aggregation, endothelin 1 level were compared.Result： The arteriovenous thrombolysis group of acute ischelnic stroke prognosis total effect rate was better than that of the control group（P〈0.05）.The arteriovenous thrombolysis group of incidence of symptomatic cerebral hemorrhage, bleeding rate were lower than the control group（P〈0.05）.Befbre intervention, two groups of nerve function defect level, life activities ability score, survival quality had no significant differences（P〉0.05）.After intervention, the arteriovenous thrombolysis group of nerve function defect level, the condition of life activities ability score, quality of life were better than those of the control group（P〈0.05）.Before intervention, two group of hypersensitive C-reactive protein, platelet aggregation, similar levels of endothelin-1 had no

关 键 词：RT-PA 急性缺血性脑卒中 动静脉联合溶栓 临床效果 

分 类 号：R743.3[医药卫生—神经病学与精神病学]