急性脑梗死经阿替普酶静脉溶栓治疗的疗效  

Effects of Alteplase Intravenous Thrombolytic Therapy for Acute Cerebral Infarction

作　　者：陈雪枝[1] CHEN Xuezhi(Department of Endocrinology,Chaozhou Central Hospital,Chaozhou Guangdong 521000,China)

机构地区：[1]潮州市中心医院内分泌科,广东潮州521000

出　　处：《中国卫生标准管理》2020年第13期74-76,共3页China Health Standard Management

摘　　要：目的探讨不同年龄急性脑梗死患者经阿替普酶静脉溶栓治疗对神经功能及血清MCP-1水平的影响。方法纳入2015年7月—2018年9月在本院神经内科急诊收治的发病4.5 h内缺血性脑卒中患进行阿替普酶静脉溶栓治疗的患者90例,依据患者的年龄分为三组,A组年龄≤60岁共37例,B组年龄61~79岁共35例,C组年龄≥80岁共18例,所有患者均采用阿替普酶治疗,对比三组患者治疗前后的美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)评分和日常生活能力依据Barthel指数评定量表(barthel index scale,BI)评分、单核细胞趋化蛋白-1(monocyte chemotactic protein-1,MCP-1)的表达。统计三组的颅内出血发生率和病死情况。结果三组患者的NIHSS评分、BI评分和MCP-1水平在治疗前对比差异无统计学意义(P>0.05),经治疗后三组患者的NIHSS评分和MCP-1水平较治疗前出现降低(P<0.05),BI评分较治疗前出现升高(P<0.05),治疗后A组和B组NIHSS评分及MCP-1水平明显低于C组(P<0.05),BI评分明显高于C组(P<0.05);A组NIHSS评分明显低于B组,BI评分明显高于B组,对比差异具有统计学意义(P<0.05),A组与B组MCP-1水平差异无统计学意义。三组患者的出血性梗死、脑实质出血、症状性颅内出血和病死情况总发生率对比差异有统计学意义(P<0.05),A组低于B组低于C组。结论不同年龄急性脑梗死患者经阿替普酶静脉溶栓治疗均可改善神经功能及血清MCP-1水平,低龄患者的获益较高龄患者的获益较高。Objective To investigate the effects of alteplase intravenous thrombolytic therapy on neurological function and serum MCP-1 levels in patients with acute cerebral infarction at different ages.Methods Ninety patients with ischemic stroke who underwent intravenous thrombolytic therapy with alteplase within 4.5 hours of onset of neurology in our hospital from July 2015 to September 2018 were enrolled.In the three groups,there were 37 patients in group A≤60 years old,35 patients in group B aged 61~79 years,and 18 patients in group C aged≥80 years.All patients were treated with alteplase,compared with the National Institute of Health stroke scale(NIHSS)scores before and after treatment in the three groups of patients,and the ability to live according to the Barthel Index Rating Scale(Barthel Index,BI)Score,expression of monocyte chemotactic protein-1(MCP-1).The incidence of intracranial hemorrhage and death were calculated in the three groups.Results The NIHSS score,BI score and MCP-1 level of the three groups of patients had no statistically significant difference before treatment(P>0.05).After treatment,the NIHSS score and MCP-1 level of the three groups of patients decreased compared with before treatment(P<0.05),the BI score was higher than before treatment(P<0.05),after treatment,the NIHSS score and MCP-1 level in group A and group B were significantly lower than group C(P<0.05),BI score was significantly higher than group C(P<0.05);the NIHSS score of group A was significantly lower than that of group B,and the BI score was significantly higher than group B.The difference was statistically significant(P<0.05).There was no statistically significant difference in the level of MCP-1 between group A and group B.There was a statistically significant difference in the total incidence of hemorrhagic infarction,parenchymal hemorrhage,symptomatic intracranial hemorrhage,and mortality among the three groups(P<0.05).Group A was lower than Group B than Group C.Conclusion Intravenous thrombolysis with alteplase in patient

关 键 词：急性脑梗死 阿替普酶 静脉溶栓 神经功能 单核细胞趋化蛋白-1 颅内出血 

分 类 号：R743[医药卫生—神经病学与精神病学]