阿替普酶静脉溶栓治疗急性脑梗死患者的出血情况、临床疗效及不良反应分析  

Analysis on bleeding,clinical efficacy and adverse reactions of alteplase intravenous thrombolysis in the treatment of patients with acute cerebral infarction

作　　者：赵子攀[1] ZHAO Zipan(Department of Neurology,Loudi Central Hospital in Hu'nan Province,Loudi 417000,China)

机构地区：[1]湖南省娄底市中心医院神经内科,湖南娄底417000

出　　处：《中国现代医生》2020年第14期81-84,共4页China Modern Doctor

摘　　要：目的 分析阿替普酶静脉溶栓治疗急性脑梗死患者的出血情况、临床疗效及不良反应.方法 选取2017年10月~2019年10月收治的116例ACI患者为研究对象,随机分为对照组和实验组,每组58例,对照组予临床常规治疗,实验组在对照组基础上予阿替普酶静脉溶栓治疗,对比两组的临床疗效、NIHSS评分、血清炎症因子指标、神经元损伤指标、不良反应.结果 实验组的临床总有效率(96.55%)高于对照组(75.86%),差异有统计学意义(P<0.05);实验组治疗1周后的NIHSS评分、血清TNF-α、IL-1β、CRP、ET、NSE因子低于对照组,差异有统计学意义(P<0.05);实验组治疗1周后的血清SOD因子高于对照组,差异有统计学意义(P<0.05);两组患者的不良反应发生率比较,差异无统计学意义(P>0.05).结论 阿替普酶静脉溶栓可有效减轻ACI患者神经功能受损程度及炎症反应,且并未增加牙龈出血等出血事件发生率,安全性较高,值得推广和应用.Objective To analyze the bleeding,clinical efficacy and adverse reactions of alteplase intravenous thrombolysis in the treatment of patients with ACI(acute cerebral infarction).Methods A total of 116 patients with ACI who were admitted to our hospital from October 2017 to October 2019 were selected as the research subjects.They were randomly divided into the control group and the experimental group,with 58 patients in each group.The control group was given routine clinical treatment,and the experimental group was given alteplase intravenous thrombolysis on the basis of the control group.The clinical efficacy,NIHSS score,serum inflammatory factor index,neuron injury index,and adverse reactions were compared between the two groups.Results The total clinical effective rate in the experimental group(96.55%)was higher than that in the control group(75.86%),and the difference was statistically significant(P<0.05);the NIHSS score,serum TNF-α,IL-1β,CRP,ET,and NSE factors in the experimental group were lower than those in the control group after 1 week of treatment,and the differences were statistically significant(P<0.05);the serum SOD factor in the experimental group was higher than that in the control group after 1 week of treatment,and the difference was statistically significant(P<0.05);there was no statistically significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion Alteplase intravenous thrombolysis can effectively reduce the degree of neurological impairment and inflammatory response in the patients with ACI,and it does not increase the incidence rate of bleeding events such as gum bleeding.The treatment is safe and worthy of being learned and applied.

关 键 词：阿替普酶 静脉溶栓 急性脑梗死 出血 临床疗效 不良反应 

分 类 号：R743.3[医药卫生—神经病学与精神病学]