重组组织型纤溶酶原激活剂治疗发病4.5～9.0h脑梗死的有效性及安全性  

Efficacy and safety of recombinant tissue plasminogen activator in the treatment of cerebral infarction within 4.5-9.0 hours

作　　者：赵冬太[1] 李雪梅[1] ZHAO Dong-tai;LI Xue-mei(Department of Emergency,the First People′s Hospital of Xinxiang City,Xinxiang 453000,Henan Province,China)

机构地区：[1]新乡市第一人民医院急诊科

出　　处：《新乡医学院学报》2019年第9期872-874,共3页Journal of Xinxiang Medical University

摘　　要：目的探讨重组组织型纤溶酶原激活剂(rt-PA)治疗发病4.5~9.0h脑梗死的有效性及安全性。方法将2013年4月至2018年3月新乡市第一人民医院收治的82例发病时间为4.5~9.0h的脑梗死患者根据治疗方法分为对照组(n=40)和观察组(n=42),对照组患者行常规治疗,观察组患者在常规治疗基础上应用rt-PA治疗。治疗前、治疗后24h及7、14d,采用美国国立卫生研究院中风量表(NIHSS)判断患者的神经功能缺损情况;治疗后90d,利用Barthel指数评估2组患者日常生活活动能力,采用修订Rankin量表(mRS)评估患者预后情况;比较2组患者不良反应发生情况。结果治疗前,2组患者NIHSS评分比较差异无统计学意义(P>0.05)。治疗后24h及7、14d,观察组患者NIHSS评分均低于对照组(P<0.05);治疗后90d,观察组患者Barthel指数高于对照组,mRS评分低于对照组(P<0.05)。对照组和观察组患者不良反应发生率分别为17.50%(7/40)和21.43%(9/42)。2组患者不良反应发生率比较差异无统计学意义(χ^2=0.201,P>0.05)。观察组患者预后理想者比例明显高于对照组(χ^2=4.010,P<0.05)。结论rt-PA治疗发病时间为4.5~9.0h的脑梗死患者,可有效减轻其机体神经功能缺损程度,增强日常生活活动能力,改善预后,且不增加不良反应发生风险。Objective To analyze the efficacy and safety of recombinant tissue plasminogen activator(rt-PA) in the treatment of cerebral infarction within 4. 5-9. 0 hours. Methods Eighty-two patients with cerebral infarction with an onset time of 4. 5-9. 0 hours were divided into control group(n = 40) and observation group(n = 42) according to the treatment method. The patients in the control group were received conventional therapy. The patients in the observation group were treated with rt-PA on the basis of conventional therapy. The neurological deficits of the patients in the two groups before treatment and at 24 hours,7 and 14 days after treatment was estimated by national institutes of health stroke scale(NIHSS). The ability of daily life activities of the patients in the two groups was evaluated by Barthel index at 90 days after treatment. The prognosis of the patients in the two groups was assessed by the modified Rankin scale(mRS). The adverse reactions in the two groups were compared. Results There was no statistically significant difference in the NIHSS scores between the two groups before treatment(P > 0. 05). The NIHSS score of patients in the observation group was lower than that in the control group at 24 hours,7 and 14 days after treatment(P < 0. 05). The Barthel score of patients in the observation group was higher than that in the control group,and mRS score was lower than that in the control group(P < 0. 05). The adverse reaction rate of the control group and observation group was 17. 50%(7/40) and 21. 43%(9/42),respectively. There was no statistically significant difference in the adverse reaction between the two groups(χ~2= 0. 201,P > 0. 05). The proportion of patients with ideal prognosis in the observation group was significantly higher than that in the control group(χ~2= 4. 010,P < 0. 05). Conclusion rt-PA treating cerebral infarction patients with onset time of 4. 5-9. 0 hours can effectively reduce the degree of neurological impairment,enhance the ability of daily life activities,improve the progn

关 键 词：脑梗死 重组组织型纤溶酶原激活剂 神经功能缺损 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]