阿替普酶静脉溶栓治疗对急性脑梗死患者神经功能及颅内血流动力学的影响  

Effect of Alteplase Intravenous Thrombolytic Therapy on Neurological Function and Intracranial Hemodynamics in Patients with Acute Cerebral Infarction

作　　者：徐春富[1] 仇圣刚[1] 沈洁玲 丁倩 XU Chunfu;QIU Shenggang;SHEN Jieling;DING Qian(Department of Neurology,Jiangdu People's Hospital of Yangzhou,Jiangdu,Jiangsu Province,225200 China)

机构地区：[1]扬州市江都人民医院神经内科,江苏江都225200

出　　处：《系统医学》2022年第24期131-134,共4页Systems Medicine

基　　金：2022年扬州市科技计划项目(YZ2020117)。

摘　　要：目的探讨对急性脑梗死患者采取阿替普酶静脉溶栓治疗的效果,及对神经功能、颅内血流动力学的改善作用。方法选择2017年1月—2022年6月扬州市江都人民医院收治的急性脑梗死患者100例,随机分为的对照组(n=50,常规治疗)与观察组(n=50,常规治疗基础上再予阿替普酶静脉溶栓治疗),采用神经功能缺损程度(NIHSS评分)评估患者治疗前与治疗后6 h、1 d、7 d和14 d的神经功能缺损状况,并比较两组治疗前与治疗1 h后的颅内血流动力学,另观察比较两组患者治疗期间的不良反应发生率。结果观察组治疗后6 h、1 d、7 d和14 d的NIHSS评分分别为(12.06±1.25)分、(10.84±1.04)分、(7.86±0.83)分、(6.10±0.67)分,均低于对照组,差异有统计学意义(t=8.492、10.284、9.466、15.765,P<0.05)。治疗1 h后,观察组患者V_(p)、V_(d)、V_(m)水平分别为(65.63±6.66)、(51.83±5.22)、(58.64±5.92)cm/s,均高于对照组,差异有统计学意义(t=3.387、3.573、3.953,P<0.05)。观察组不良反应发生率(8.00%)与对照组(4.00%)比较,差异无统计学意义(P>0.05)。结论对急性脑梗死患者在常规治疗基础上再予阿替普酶静脉溶栓治疗可显著减轻患者的神经功能缺损程度,促进患者颅内血流动力学,且不会明显增加不良反应,具有较高的药物安全性。Objective To investigate the effect of intravenous thrombolytic therapy with alteplase in patients with acute cerebral infarction,and to improve the neurological function and intracranial hemodynamics.Methods 100 patients with acute cerebral infarction admitted to Yangzhou Jiangdu People's Hospital from January 2017 to June 2022 were randomly divided into the control group(n=50,conventional treatment)and the observation group(n=50,intravenous thrombolytic therapy with alteplase on the basis of conventional treatment).The degree of neurological deficit(NIHSS score)was used to evaluate the neurological deficit of patients before and after treatment at 6 h,1 d,7 d and 14 d,and to compare the intracranial hemodynamics of the two groups before and after treatment at 1 h,and to observe and compare the incidence of adverse reactions in the two groups during treatment.Results The NIHSS scores of the observation group were(12.06±1.25)points,(10.84±1.04)points,(7.86±0.83)points and(6.10±0.67)points,respectively,6 h,1 d,7 d and 14 d after treatment,which were lower than those of the control group,and the difference was statistically significant(t=8.492,10.284,9.466,15.765,P<0.05).After one hour of treatment,the levels of V_(p),V_(d) and V_(m) in the observation group were(65.63±6.66)cm/s,(51.83±5.22)cm/s and(58.64±5.92)cm/s,respectively,which were significantly higher than those in the control group,and the difference was statistically significant(t=3.387,3.573,3.953,P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the observation group(8.00%)and the control group(4.00%)(P>0.05).Conclusion For patients with acute cerebral infarction,intravenous thrombolytic therapy with alteplase on the basis of conventional treatment can significantly reduce the degree of neurological impairment,promote the intracranial hemodynamics of patients,and will not significantly increase adverse reactions,with high drug safety.

关 键 词：急性脑梗死 阿替普酶 静脉溶栓治疗 神经功能 颅内血流动力学 

分 类 号：R4[医药卫生—临床医学]