小剂量rt-PA静脉溶栓治疗高龄超急性期脑梗死患者的临床分析  

Clinical Analysis of Intravenous Thrombolysis with Low dose rt-PA in Elderly Patients with Hyperacute Cerebral Infarction

作　　者：孟庆贵 MENG Qinggui(Department of Neurology,Dandong First Hospital,Dandong 118000,China)

机构地区：[1]丹东市第一医院神经内科,辽宁丹东118000

出　　处：《中国医药指南》2020年第29期89-90,共2页Guide of China Medicine

摘　　要：目的探讨小剂量重组组织型纤溶酶原激活物(rt-PA)静脉溶栓治疗高龄超急性期脑梗死患者的临床效果。方法选择2017年7月至2018年7月76例高龄超急性期脑梗死患者,随机分为两组各38例,研究组采取小剂量rt-PA静脉溶栓治疗,对照组采取尿激酶溶栓治疗。比较两组不同时点的NIHSS评分,并判断3个月内的临床疗效。结果两组溶栓后的NIHSS评分均在持续下降,研究组溶栓后2 h、24 h的NIHSS评分明显低于对照组(P<0.05),溶栓后72 h、1周、2周的NIHSS评分与对照组比较差异无统计学意义(P>0.05)。研究组总有效率为84.21%,高于对照组的52.63%(P<0.05);研究组总不良反应率为13.15%,对照组总不良反应率为15.78%,两组差异无统计学意义(P>0.05)。结论小剂量rt-PA静脉溶栓治疗高龄超急性期脑梗死患者能够快速改善神经功能,提高疗效。Objective To investigate the clinical effect of intravenous thrombolysis with low dose recombinant tissue-type plasminogen activator(rt-PA)in the treatment of elderly patients with hyperacute cerebral infarction.Methods Seventy-six cases of elderly patients with hyperacute cerebral infarction from July 2017 to July 2018 were selected and randomly divided into two groups with 38 cases in each group.Low dose rt-PA intravenous thrombolysis was used in the study group,and urokinase thrombolysis was used in the control group.The NIHSS scores of the two groups at different time points were compared,and the clinical efficacy within 3 months was determined.Results The NIHSS scores of the two groups continued to decline after thrombolysis.The NIHSS scores of the study group at 2 hours and 24 hours after thrombolysis were significantly lower than those of the control group(P<0.05),and the NIHSS at 72 hours,1 week and 2 weeks after thrombolysis there was no statistically significant difference between the score and the control group(P>0.05).The total effective rate of the study group was 84.21%,which was higher than 52.63%of the control group(P<0.05);the total adverse reaction rate of the study group was 13.15%,and the total adverse reaction rate of the control group was 15.78%.There was no statistically significant difference between the two groups(P>0.05).Conclusion Low dose rt-PA intravenous thrombolysis can rapidly improve the neurological function and improve the efficacy in elderly patients with hyperacute cerebral infarction.

关 键 词：脑梗死 静脉溶栓 重组组织型纤溶酶原激活物 

分 类 号：R743.33[医药卫生—神经病学与精神病学]