急性脑梗死超早期静脉溶栓对脑心综合征的疗效观察  

Therapeutic effect of intravenous thrombolysis in super-early stage of cerebral infarction on cerebralcardiac syndrome

作　　者：高金立[1] 刘尖尖[1] 薛迎红[1] Gao Jinli;Liu Jianjian;Xue Yinghong(Department of Neurology,the Fuxing Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属复兴医院神经内科

出　　处：《脑与神经疾病杂志》2019年第8期502-505,共4页Journal of Brain and Nervous Diseases

摘　　要：目的研究急性脑梗死(ACI)发病后2h(超早期)溶栓对脑心综合征(BHS)的疗效。方法选择首都医科大学附属复兴医院神经内科住院27例ACI合并BHS,且经重组人组织型纤溶酶原激活物(rt-PA)溶栓治疗患者,根据发病到溶栓用药时间分为超早期组(<2h)和早期组(2~4.5h),分别抽取发病后24h内(次日5AM采血)及第3天高灵敏度肌钙蛋白T(hs-cTnT)及肌酸激酶同I酶MB(CKMB),评估超早期溶栓治疗对减低BHS严重程度,及加快BHS好转的作用。结果ACI合并BHS溶栓治疗患者27例,发病到溶栓用药时间<2h组13例,2~4.5h组14例。两组病例年龄,性别及发病到采血时间比较,(P>0.05),<2h组和2~4.5h组溶栓前NIHSS评分比较,(P>0.05),<2h组和2~4.5h组溶栓前后NIHSS评分比较,差异有统计学意义(P<0.05),<2h组溶栓前后NIHSS评分比较,(P<0.05),2~4.5h组溶栓前后NIHSS评分比较,(P>0.05),两组发病后24h内hs-cTnT及CK-MB比较,(P<0.05),3日后hs-cTnT好转比较,(P<0.05),CK-MB好转比较,(P>0.05)。结论ACI合并脑心综合征患者,在发病2h内溶栓,对减低BHS严重程度及加快BHS好转有意义。Objective To study the effect of thrombolysis in 2 hours after onset on acute cerebral infarction(ACI)with brain-heart syndrome(BHS).Methods 27 ACI patients with BHS treated by intravenous rt-PA therapy were retrospectively studied,and were divided into two groups.Super-early group(treated within 2 hours,13 cases)and early group(treated between 2-4.5hs,14 cases).The hs-cTnT and CK-MB were extracted in 24 hours and the third days after onset respectively.The effect of ultra-early thrombolytic therapy on reducing the severity of BHS,and improving of BHS was evaluated.Results 27 patients with ACI complicated with BHS were treated with thrombolytic therapy.The time from onset to thrombolytic therapy was less than 2 hours in 13 cases and 2-4.5 hours in 14 cases.There was no significant difference in age,sex and time difference that hs-cTnT and CK-MB were extracted(P>0.05).There was no significant difference in NIHSS score before thrombolysis between the 2 groups(P>0.05).There was significant difference in NIHSS score before and after thrombolysis in all the cases(P<0.05).There was significant difference in NIHSS score before and after thrombolysis in<2 hours group(P<0.05),but not in 2-4.5 hours group(P>0.05).There was statistical significance in the improvement of hs-cTnT and CK-MB in 24 hours(P<0.05).There was statistical significance in the improvement of hs-cTnT in 3 days(P<0.05),but not in CKMB(P>0.05).Conclusions Super-early thrombolysis therapy,using within 2 hours,may significantly reduce the severity of BHS and get better improvement.

关 键 词：急性脑梗死 溶栓 脑心综合征 

分 类 号：R743.32[医药卫生—神经病学与精神病学]