不同剂量重组组织型纤溶酶原激活物静脉溶栓治疗高龄急性脑梗死患者的有效性及安全性分析  

Efficacy and safety of different doses of recombinant tissue plasminogenactivator in the treatment of senile acute cerebral infarction PDF (PC) 16

作　　者：喻明[1] 陈小容[1] 李琳琳[1] 徐磊[1] 何晓非[1] 张运伟[1] 刘莉[1] 杨小芳[1] Yu Ming;Chen Xiaorong;Li Linlin;Xu Lei;He Xiaofei;Zhang Yunwei;Liu Li;Yang Xiaofang(Department of Neurology, Suining central hospital, Suining 629000, China)

机构地区：[1]四川省遂宁市中心医院神经内科,629000

出　　处：《临床内科杂志》2019年第9期612-614,共3页Journal of Clinical Internal Medicine

摘　　要：目的观察不同剂量重组组织型纤溶酶原激活物(rt-PA)静脉溶栓治疗高龄(≥80岁)急性脑梗死患者的疗效及安全性。方法应用rt-PA对78例急性脑梗死患者进行静脉溶栓治疗,根据药物剂量分为小剂量(0.6mg/kg)组40例和标准剂量(0.9mg/kg)组38例;另选取39例未接受溶栓治疗患者为非溶栓组,比较3组患者的临床疗效、美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分、颅内出血发生率和死亡率。结果小剂量组与标准剂量组总有效率比较差异无统计学意义(P>0.05),且均高于非溶栓组(P<0.05)。小剂量组与标准剂量组治疗后1d、7d、15d、30dNIHSS评分比较差异无统计学意义(P>0.05),且均明显低于非溶栓组(P<0.05)。小剂量组与标准剂量组mRS评分比较差异无统计学意义(P>0.05),且均明显低于非溶栓组(P<0.05)。小剂量组24h颅内出血率明显低于标准剂量组(P<0.05);小剂量组、标准剂量组24h颅内出血率均高于非溶栓组(P<0.05)。小剂量组与标准剂量组死亡率比较,差异无统计学意义(P>0.05),均明显低于非溶栓组(P<0.05)。结论静脉溶栓治疗高龄急性脑梗死患者较为安全、有效,小剂量rt-PA可以降低患者出血风险,减少神经功能缺损。Objective To observe the efficacy and safety of different doses of recombinant tissue plasminogen activator(rt-PA) intravenous thrombolysis in the treatment of senile acute cerebral infarction(≥80 years old).Methods Seventy-eight patients with acute cerebral infarction were treated with intravenous thrombolysis using rt-PA,and were divided into low-dose group(0.6mg/kg,40 cases) and standard group(0.9mg/kg,38 cases) according to the drug dose.There were 39 cases in the non-thrombolytic group.Clinical efficacy,National Institutes of Health Stroke scale (NIHSS),modified Rankin Scale(mRS),incidence of intracranial hemorrhageand mortality of the three groups were compared.Results There was no significant difference in total effective rate between low-dose group and standard dose group (P>0.05),and were both higher than that in the non-thrombolytic group(P<0.05).There was no significant difference in NIHSS scores between low-dose group and standard dose group on 1d,7d,15d and 30d after treatment (P>0.05),and were significantly lower than those of the non-thrombolytic group (P<0.05).There was no significant difference in mRS scores between low-dose group and standard dose group(P>0.05),and were significantly lower than that of non-thrombolytic group(P<0.05).The intracranial hemorrhage rate in low-dose group was significantly lower than that in standard dose group(P<0.05).The intracranial hemorrhage rates in low-dose group and standard dose group were higher than that in non-thrombolytic group(P<0.05).There was no significant difference in the mortality between low-dose group and standard dose group(P>0.05),and were significantly lower than that in non-thrombolytic group(P<0.05).Conclusion Venous thrombolysis is safe and effective in the treatment of senile acute cerebral infarction.Small dose of rt-PA can reduce the risk of bleeding and reduce the neurological deficit.

关 键 词：高龄急性脑梗死 重组组织型纤溶酶原激活物 静脉溶栓治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学]