rt-PA静脉溶栓治疗急性脑梗死患者的疗效及安全性分析  

Efficacy and Safety of rt-PA Intravenous Thrombolysis in Patients with Acute Cerebral Infarction

作　　者：张勇[1] 杜圆圆[1] ZHANG Yong;DU Yuanyuan(Department of Neurology,Bayannaoer Hospital,Bayannaoer 015000,China)

机构地区：[1]巴彦淖尔市医院神经内科,内蒙古巴彦淖尔015000

出　　处：《医学综述》2020年第7期1448-1451,1456,共5页Medical Recapitulate

摘　　要：目的探讨重组人组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗急性脑梗死患者的疗效及安全性。方法选取2018年6月至2019年6月巴彦淖尔市医院收治的70例急性脑梗死患者为研究对象,按照治疗方法不同分为对照组和观察组,每组35例。其中,对照组予以常规治疗,包括抗栓、清除自由基、调节血脂等;观察组在对照组的基础上予以rt-PA静脉溶栓治疗,疗程为2周。治疗后,比较两组患者的临床疗效,治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、巴塞尔指数(BI)评分,以及不良事件和预后情况。结果治疗后,观察组的总有效率高于对照组[91.43%(32/35)比71.43%(25/35)](P<0.05)。治疗后,两组患者的NIHSS评分降低,且观察组低于对照组[(8.25±1.11)分比(11.05±1.67)分](P<0.05),两组患者NIHSS评分的组间、时点间、组间和时点间交互作用比较差异有统计学意义(P<0.05)。治疗后,两组患者的BI评分升高,且观察组高于对照组[(75.94±9.54)分比(59.87±7.61)分](P<0.05),两组患者BI评分的组间、时点间、组间和时点间交互作用比较差异有统计学意义(P<0.01)。观察组总不良事件发生率低于对照组[2.86%(1/35)比17.14%(6/35)](P<0.05);观察组预后良好率高于对照组[85.7%(30/35)比62.86%(22/35)](P<0.05)。结论rt-PA静脉溶栓治疗有助于提高急性脑梗死患者的临床治疗效果,降低NIHSS评分,减少不良事件的发生。Objective To investigate the efficacy and safety of recombinant human tissue plasminogen activator(rt-PA)intravenous thrombolysis in patients with acute cerebral infarction.Methods Seventy patients with acute cerebral infarction admitted from Bayannaoer Hospital from Jun.2018 to Jun.2019 were included and divided into a control group and an observation group according to treatment methods,with 35 patients in each group.The control group was given conventional treatment,including antithrombotics,scavenging free radicals,regulating blood lipids,etc.The observation group was given rt-PA intravenous thrombolytic therapy on the basis of the control group′s regimen,and the course of treatment was 2 weeks.After treatment,the clinical efficacy,National Institutes of Health stroke scale(NIHSS)score,Basel index(BI)score,adverse events and prognosis were compared between the two groups.Results After treatment,the total effective rate in the observation group was higher than that in the control group[91.43%(32/35)vs 71.43%(25/35)](P<0.05).After treatment,the NIHSS score of the two groups decreased,and the observation group was lower than the control group[(8.25±1.11)vs(11.05±1.67)](P<0.05).There were significant differences in NIHSS score between groups,time points,and interactions of groups and time points(P<0.05).After treatment,the BI score of the two groups increased,and the observation group was higher than the control group[(75.94±9.54)vs(59.87±7.61)](P<0.05),and there were significant differences between groups,time points,and interactions of groups and time points(P<0.01).The incidence of adverse events in the observation group was lower than the control group[2.86%(1/35)vs 17.14%(6/35)](P<0.05).The good prognosis rate in the observation group was higher than the control group[85.7%(30/35)vs 62.86%(22/35)](P<0.05).Conclusion Intravenous thrombolytic therapy with rt-PA is helpful to improve the clinical effect,lower the NIHSS score,and reduce the occurrence of adverse events of patients with acute cerebral infar

关 键 词：急性脑梗死 重组人组织型纤溶酶原激活剂 静脉溶栓 疗效 安全性 

分 类 号：R743.33[医药卫生—神经病学与精神病学]