前后循环小卒中静脉溶栓的有效性及安全性对比研究  

Comparative studies on the efficacy and safety of intravenous thrombolysis with anterior and posterior circulation mild stroke

作　　者：付静 窦海玲 李世泽 FU Jing;DOU Hailing;LI Shize(Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属郑州中心医院

出　　处：《中国实用神经疾病杂志》2019年第15期1649-1655,共7页Chinese Journal of Practical Nervous Diseases

摘　　要：目的对比前、后循环急性缺血性小卒中患者重组组织型纤溶酶原激活剂(alteplase rt-PA)静脉溶栓的安全性及有效性。方法回顾性分析接受rt-PA静脉溶栓治疗的335例急性缺血性小卒中患者的临床资料,其中前循环缺血性小卒中(ACMS)245例,后循环(PCMS)90例,通过分析患者入院时、24 h及14 d NIHSS评分,90 d mRS评分,早期症状改善率,临床症状恶化率,90 d功能独立率,症状性颅内出血及90 d死亡情况,比较2组临床疗效及安全性。结果ACMS组24 h NIHSS评分(2.5±0.98 vs 3.4±1.01)、90 d mRS评分(0.8±0.56 vs 1.5±0.68)、临床症状恶化率(6.12%vs 13.3%)显著低于PCMS组(P<0.05),早期症状改善率(68.1%vs 48.9%)、功能性独立率(91.4%vs 80%)及出血转化率(2.44%vs 0)显著高于PCMS组(P<0.05);2组90 d病死率均为0。结论前循环缺血性小卒中rt-PA静脉溶栓有效性优于后循环,但后循环缺血性小卒中rt-PA静脉溶栓安全性优于前循环;小卒中rt-PA静脉溶栓可能是安全有效的。Objective To investigate the safety and efficacy of rt-PA intravenous thrombolysis in patients with anterior and posterior ischemic disability-causing stroke.Methods Clinical data of 335 mild stroke patients with rt-PA intravenous thrombolysis were retrospectively analyzed.The patients were divided into anterior circulation mild stroke(ACMS)group(n=245)and posterior circulation mild stroke(PCMS)group(n=90).NIHSS score of 24 h and 14 d,90 d mRS score,clinical deterioration rate,and 90 d function independent rate,intracranial hemorrhage and mortality of two groups were compared.Results 24 h NIHSS score(2.5±0.98 vs 3.4±1.01),90 d mRS score(0.8±0.56 vs 1.5±0.68),clinical symptom deterioration rate(6.12%vs 13.3%),early symptom improvement rate(68.1%vs 48.9%),functional independence rate(91.4%vs 80%)and intracranial hemorrhage rate(2.44%vs 0)of ACMS group were significantly lower than PCI group(P<0.05).The 90 d mortality in both groups was 0.Conclusion The efficacy of ACMS is better than PCMS,but the safety of PCMS is better than ACMS.

关 键 词：前循环 后循环 缺血性小卒中 静脉溶栓 重组组织型纤溶酶原激活剂 

分 类 号：R743.33[医药卫生—神经病学与精神病学]