rt-PA溶栓治疗急性缺血性脑卒中后脑出血的研究进展  

Research progress on cerebral hemorrhage caused by rt-PA thrombolytic therapy in acute ischemic stroke patients

作　　者：姚沫如 苏丹颖[1] Yao Moru;Su Danying(Neurology Department, the Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China)

机构地区：[1]哈尔滨医科大学附属第四医院神经内科,150001

出　　处：《神经疾病与精神卫生》2019年第5期533-537,共5页Journal of Neuroscience and Mental Health

摘　　要：重组组织型纤溶酶原激活物(rt-PA)溶栓治疗急性缺血性脑卒中(AIS)后脑出血是溶栓治疗中的严重并发症。rt-PA在局部溶栓的同时增加了机体出血风险,可能导致脑出血性转化(CHT),其发病与纤溶酶原激活物抑制剂1(PAI1)和凝血酶激活的纤溶抑制物(TAFI)的基因多态性和生理差异有关。体温、年龄、头颅CT或MRI的影像表现、血压和血糖等多种因素均是影响rt-PA溶栓治疗AIS后脑出血的因素。在rt-PA溶栓治疗中,针对不同生理状态和临床特征的AIS患者进行预见性地监测和目的性地护理具有重要的临床意义。Cerebral hemorrhage in acute ischemic stroke (AIS) patients is a serious complication after thrombolytic therapy using recombinant tissue plasminogen activator (rt-PA). The rt-PA increases the risk of bleeding while treating local thrombolysis, which potentially leads to cerebral hemorrhagic transformation (CHT). This process is related to the gene polymorphism and physiological differences of plasminogen activator inhibitor 1 (PAI1) and thrombin-activatable fibrinolysis inhibitor (TAFI). Body temperature, age, brain CT or MRI imaging, blood pressure and blood sugar levels are factors that can affect the likelihood of cerebral hemorrhage caused by rt-PA thrombolytic therapy while treating AIS. In rt-PA thrombolytic therapy, it is of great clinical importance to adopt predictive monitoring and purposeful nursing for AIS patients with different physiological conditions and clinical characteristics.

关 键 词：重组组织型纤溶酶原激活物 缺血性脑卒中 脑出血性转化 纤溶酶原激活物抑制剂 1 凝血酶激活的纤溶抑制物 综述 

分 类 号：R743.31[医药卫生—神经病学与精神病学]