阿替普酶治疗不同时间窗发病急性脑梗死疗效观察  

作　　者：张叶青 王金华 陶涛涛 林霞 陈秋月 张丹红 

机构地区：[1]浙江省台州市中心医院(台州学院附属医院),503141

出　　处：《浙江临床医学》2021年第1期79-80,83,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划项目(2019KY789);浙江省台州市科技计划项目(1801ky33)。

摘　　要：目的观察不同剂量阿替谱酶(rt-PA)治疗不同时间窗发病急性脑梗死的疗效观察。方法选择2019年1月至12月于发病<4.5 h行rt-PA静脉溶栓治疗的急性脑梗死患者122例,对其资料进行回顾性分析。按照发病时间窗、rt-PA剂量不同分为4组,发病至用药时间<3 h为Ⅰ组,rt-PA剂量0.6mg/kg(Ⅰa组),0.9 mg/kg(Ⅰb组);发病至用药3~4.5 h为Ⅱ组,rt-PA剂量0.6 mg/kg(Ⅱa组),0.9 mg/kg(Ⅱb组)。比较4组患者间溶栓治疗后2h、24 h、7 d神经功能缺损量表(NIHSS)评分改善情况。结果Ⅰa组与Ⅱa组比较,溶栓后2h、24h、7d NIIHSS改善程度较后者明显(P<0.05);Ⅰb组与Ⅱb组比较,溶栓后2 h NIHSS改善程度较后者明显(P<0.05)。Ⅰ组与型组比较,2h、24 h、7 d症状程度明显改善(P<0.05)。结论超早期应用rt-PA,治疗时间窗越短,早期疗效越佳。Objective To observe the efficacy and safety of different doses of arteplasc(rt-PA)in the treatment of acute cerebral infarction at different time windows.Method 122 patients with acute cerebral infarction who were hospitalized in neurology department of Taizhou Central Hospital from January 1^st 2019 to December 31^st 2019 and received rt-PA intravenous thrombolytic therapy within 4.5 hours after onset were selected,and they were analyzed retrospectively.According to the time window of onset and the dosage of rt-PA,the patients were divided into four groups.According to the time from onset to medication,the dosage of rt-PA was less than 3 hours,and the dosage of rt-PA was 0.6 mg/kg(Ⅰa group),the dosage of rt-PA was 0.9 mg/kg(Ⅰb group).From onset to medication 3-4.5 hours,and the dosage of rt PA was 0.6 mg/kg(Ⅱa group),The dose of rt-PA was 0.9 mg/kg(Ⅱb group).The baseline clinical data,NIHSS scores at admission and 2hours,24hours and 7 days after thrombolytic therapy,Improvement of symptoms were compared among the four groups.Results The improvement of neurological deficit symptoms inⅠa group was significandy higher than that in Ⅰb group at 2 hours,24 hours and 7days after thrombolytic therapy(P<0.05);the improvement of neurological deficit symptoms in Ⅰb group was significandy higher than that in Ⅱb group at 2 hours after thrombolytic therapy(P<0.05).The improvement of neurological deficit symptoms in Ⅰa+Ⅰb group was significandy better than that in Ⅱa+Ⅱb group at 2hours,24hours and 7days(P<0.05).Conclusion The shorter the therapeutic time window,the better the early curative effect of rt-PA in the ultra-early stage.

关 键 词：脑梗死 阿替普酶 溶栓 时间窗 剂量 

分 类 号：R74[医药卫生—神经病学与精神病学]