阿替普酶静脉溶栓治疗急性脑梗死的临床疗效及预后分析  

Clinical efficacy and prognosis analysis of intravenous thrombolysis with alteplase in the treatment of acute cerebral infarction

作　　者：李淑芳[1] 牛福来[1] 杨瑞霞[1] 于甜甜[1] Li Shufang;Niu Fulai;Yang Ruixia;Yu Tiantian(Department of Neurology,Jiyuan People′s Hospital,Jiyuan Henan 459000,China)

机构地区：[1]济源市人民医院神经内科,河南济源459000

出　　处：《保健医学研究与实践》2022年第2期23-27,共5页Health Medicine Research and Practice

摘　　要：目的探讨阿替普酶静脉溶栓治疗急性脑梗死(ACI)的效果及预后。方法回顾性分析2016年3月—2019年3月济源市某医院收治的107例ACI患者的临床资料,根据治疗方式分为研究组(n=57)和对照组(n=50)。对照组采用常规溶栓治疗,研究组采用阿替普酶静脉溶栓治疗,比较2组患者的临床疗效、早期溶栓后症状改善情况及不良反应发生情况,采用多元Logistic回归分析患者预后的影响因素。结果2组患者治疗后1周及治疗后1个月时美国国立卫生研究院卒中量表(NIHSS)评分低于治疗前且研究组低于对照组,Barthel指数(BI)高于治疗前且研究组高于对照组,差异均有统计学意义(P<0.05)。研究组患者治疗总有效率为98.25%,高于对照组的82.00%,差异有统计学意义(χ^(2)=6.490,P=0.011)。研究组患者不良反应发生率为3.51%,低于对照组的18.00%,差异有统计学意义(χ^(2)=6.064,P=0.014)。预后良好与预后不良患者年龄、营养状况、治疗前NIHSS评分、溶栓治疗方式比较,差异有统计学意义(P<0.05)。多因素分析结果显示,营养状况不良、治疗前NIHSS评分≥16分、常规溶栓治疗是影响ACI患者预后的危险因素(P<0.05)。结论阿替普酶静脉溶栓治疗ACI患者临床疗效显著,且影响ACI患者预后的危险因素较多,应采用合理措施对合并危险因素的高危患者进行干预以改善预后。Objective To investigate the effect and prognosis of intravenous thrombolysis with alteplase for acute cerebral infarction(ACI).Methods The clinical data of 107 patients with ACI admitted to a hospital in Jiyuan from March 2016 to March 2019 were retrospectively analyzed and divided into a study group(n=57)and a control group(n=50)according to the treatment method.The control group was treated with conventional thrombolysis and the study group was treated with intravenous thrombolysis with aprotinin,and the clinical efficacy,improvement of early thrombolytic symptoms and occurrence of adverse reactions in the 2 groups were compared,and the factors influencing the prognosis of patients were analyzed by multivariate logistic regression.Results The NIHSS scores were lower in the study group than in the control group at 1 week and 1 month after treatment,and the Barthel Index(BI)was higher in the study group than in the control group,and the differences were statistically significant(P<0.05).The total effective rate of treatment for patients in the study group was 98.25%,which was higher than that of 82.00%in the control group,and the difference was statistically significant(χ^(2)=6.490,P=0.011).The incidence of adverse reactions in patients in the study group was 3.51%,which was lower than that of 18.00%in the control group,and the difference was statistically significant(χ^(2)=6.064,P=0.014).The differences were statistically significant(P<0.05)when comparing the age,nutritional status,pre-treatment NIHSS score,and thrombolytic treatment method in patients with good prognosis to those with poor prognosis.The results of multifactorial analysis showed that poor nutritional status,pretreatment NIHSS score≥16,and conventional thrombolytic treatment were risk factors affecting the prognosis of patients with ACI(P<0.05).Conclusion The clinical efficacy of intravenous thrombolysis with alteplase in ACI patients is significant,and there are many risk factors affecting the prognosis of ACI patients,and reasonable measur

关 键 词：阿替普酶静脉溶栓 急性脑梗死 临床疗效 预后 

分 类 号：R743.32[医药卫生—神经病学与精神病学]