不同时间窗rt-PA静脉溶栓治疗急性脑梗死的临床疗效评价  

Evaluation on the clinical efficacy of intravenous thrombolysis with rt-PA in patients with acute cerebral infarction in different time windows

作　　者：王丹 WANG Dan(Zhongyi Northeast International Hospital,Shenyang 110170,China)

机构地区：[1]中一东北国际医院,110170

出　　处：《中国实用医药》2021年第34期37-39,共3页China Practical Medicine

摘　　要：目的探讨不同时间窗急性脑梗死患者应用重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗的临床疗效。方法114例急性脑梗死患者,根据发病时间不同分为A组(54例,发病时间<3.0 h)与B组(60例,发病时间3.0~4.5 h)。两组均应用rt-PA静脉溶栓治疗,比较两组治疗效果,治疗前后美国国立卫生研究院卒中量表(NIHSS)评分,不良事件发生情况,不同时期的改良Rankin量表(mRS)评分。结果A组治疗总有效率为88.9%,高于B组的73.3%,差异有统计学意义(P<0.05)。治疗前、治疗后24 h、治疗后7 d,两组NIHSS评分组间比较,差异无统计学意义(P>0.05);两组治疗后7 d的NIHSS评分均低于本组治疗前及治疗后24 h,差异有统计学意义(P<0.05)。两组不良事件发生率比较,差异无统计学意义(P>0.05)。治疗后6个月,两组mRS评分比较差异无统计学意义(P>0.05);治疗后1年,A组mRS评分(3.07±0.27)分低于B组的(3.71±0.23)分,差异有统计学意义(P<0.05)。结论急性脑梗死患者发病4.5 h内进行rt-PA静脉溶栓治疗可有效恢复患者脑神经功能,提升患者存活率,降低残疾率,且应用药物治疗越早,治疗效果较好。Objective To discuss the clinical efficacy of intravenous thrombolysis with recombinant tissue plasminogen activator(rt-PA)in patients with acute cerebral infarction in different time windows.Methods A total of 114 patients with acute cerebral infarction were divided into group A(54 cases,onset time<3.0 h)and group B(60 cases,onset time 3.0-4.5 h)according to the time of onset.The therapeutic effect,National Institutes of Health stroke scale(NIHSS)scores before and after treatment,occurrence of adverse events,and modified Rankin scale(mRS)scores in different periods were compared between the two groups.Results The total effective rate of treatment in group A was 88.9%,which was higher than 73.3%in group B,and the difference was statistically significant(P<0.05).Before treatment,24 h after treatment,and 7 d after treatment,there was no statistically significant difference between the two groups of NIHSS score(P>0.05).The NIHSS scores of the two groups 7 d after treatment were lower than those of this group before treatment and 24 h after treatment,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse events between the two groups(P>0.05).6 months after treatment,there was no statistically significant difference in mRS scores between the two groups(P>0.05).1 year after treatment,the mRS score(3.07±0.27)points of group A was lower than(3.71±0.23)points of group B,and the difference was statistically significant(P<0.05).Conclusion rt-PA intravenous thrombolysis within 4.5 h of onset of acute cerebral infarction can effectively restore cerebral nerve function,improve the survival rate of patients,lower the rate of disability.The earlier the application of drug treatment,the better the therapeutic effect.

关 键 词：不同时间窗 重组组织型纤溶酶原激活剂 静脉溶栓 急性脑梗死 

分 类 号：R743.33[医药卫生—神经病学与精神病学]