低剂量与标准剂量阿替普酶静脉溶栓治疗高龄急性缺血性脑卒中患者的临床疗效对比  

Clinical efficacy of intravenous thrombolysis with low-dose and standard-dose alteplase is similar in the treatment of elderly patients with acute ischemic stroke

作　　者：朱建建[1] 李骥[2] 邹丽[1] 樊兴娟[3] 沈海清[1] 单梅芳[1] ZHU Jian-jian;LI Ji;ZOU Li;FAN Xing-juan;SHEN Hai-qing;SHAN Mei-fang(Department of Neurology, the People’s Hospital of Rugao, Rugao 226500, Jiangsu, China;Department of Ultrasound, the People’s Hospital of Rugao, Rugao 226500, Jiangsu, China;Department of Neurology, the Affiliated Hospital of Nantong University, Nantong 226000, Jiangsu, China)

机构地区：[1]如皋市人民医院神经内科,如皋226500 [2]如皋市人民医院超声科,如皋226500 [3]南通大学附属医院神经内科,南通226000

出　　处：《中国临床医学》2018年第6期945-948,共4页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨低剂量(0.6mg/kg)与标准剂量(0.9mg/kg)阿替普酶静脉溶栓治疗高龄(年龄>80岁)急性脑梗死患者的疗效与安全性。方法:将40例发病3h内的高龄脑卒中患者分为阿替普酶低剂量组(n=21)和标准剂量组(n=19),比较两组患者的一般情况、美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、出血事件、发病90d改良Rankin量表(mRS)评分和90d死亡率。结果:低剂量组与标准剂量组患者一般临床资料、基线NIHSS评分、溶栓24h及溶栓7dNIHSS差异无统计学意义。低剂量组与标准剂量组患者出血性脑梗死发生率、发病90d死亡率以及90d的mRS评分0～2分患者比例差异均无统计学意义。结论:高龄急性缺血性脑卒中患者早期低剂量与标准剂量阿替普酶静脉溶栓的疗效及安全类似。Objective:To investigate the efficacy and safety of intravenous thrombolytic therapy with low-dose(0.6mg/kg)or standard-dose(0.9mg/kg)alteplase in the treatment of elderly patients(age>80years)with acute ischemic stroke.Methods:Fourty elderly patients with acute ischemic stroke within3hours after onset were randomly divided into two groups:21patients in the low-dose alteplase group and19patients in the standard-dose alteplase group.The general situation,National Institute of Health stroke scale(NIHSS)scores,bleeding events,modified Rankin Scale(mRS)score after90days of morbidity,and90-day mortality were compared between the two groups.Results:There was no significant difference in general clinical data,baseline NIHSS score,and24h and7d NIHSS score between low-dose group and standard-dose group.And no significant difference was found in the incidence of intracranial hemorrhage,the90-day mortality,and the ratio of90-day mRS score of0-2between the two groups.Conclusions:Low-dose alteplase has similar efficacy and safety profile compared with standard-dose alteplase in elderly patients with acute ischemic stroke.

关 键 词：高龄 急性缺血性脑卒中 静脉溶栓 阿替普酶 

分 类 号：R743.3[医药卫生—神经病学与精神病学]