经颅多普勒超声联合小剂量阿替普酶静脉溶栓治疗急性脑梗死的临床研究  

Clinical study of transcranial Doppler ultrasound combined with low-dose alteplase intravenous thrombolysis in the treatment of acute cerebral infarction

作　　者：林美容 李世博[1] 李萍欢 LIN Mei-rong;LI Shi-bo;LI Ping-huan(Kaiping Central Hospital,Jiangmen 529000,China)

机构地区：[1]开平市中心医院,529000

出　　处：《中国实用医药》2024年第4期93-96,共4页China Practical Medicine

基　　金：江门市医疗卫生领域科技计划项目(项目编号:2022YL10003)。

摘　　要：目的分析经颅多普勒超声+小剂量阿替普酶静脉溶栓对急性脑梗死治疗效果。方法以50例急性脑梗死患者作为研究对象,使用随机数字表法分为研究组与对照组,各25例。研究组实施经颅多普勒超声+0.6 mg/kg小剂量(最高总剂量≤50 mg)阿替普酶静脉溶栓治疗,对照组实施0.9 mg/kg阿替普酶(最高剂量≤90 mg)静脉溶栓治疗。对比两组大脑中动脉血流动力学、不同时间的美国国立卫生研究院卒中量表(NIHSS)评分、血管再通率、不良反应发生情况。结果研究组舒张末期血流速度(Vd)、平均血流速度(Vm)、收缩期峰值血流速度(Vp)分别为(23.75±10.25)、(40.53±10.15)、(81.26±15.14)cm/s,均快于对照组的(18.22±7.23)、(32.47±10.16)、(70.30±15.12)cm/s,差异有统计学意义(P<0.05)。溶栓前、溶栓后2 h,两组NIHSS评分对比,差异无统计学意义(P>0.05);溶栓后24 h、28 d,研究组NIHSS评分(9.45±1.19)、(7.25±1.17)分,均低于对照组的(12.33±1.13)、(8.12±1.19)分,差异有统计学意义(P<0.05)。对照组血管再通率76.00%低于研究组的96.00%,差异有统计学意义(P<0.05)。对照组不良反应发生率24.00%高于研究组的4.00%,差异有统计学意义(P<0.05)。结论经颅多普勒超声+小剂量阿替普酶静脉溶栓价值较高,可以帮助患者改善神经功能、血流动力学情况,对加快疾病恢复进程具有积极意义,可加以推广。Objective To analyze the effect of transcranial Doppler ultrasound combined with low-dose alteplase intravenous thrombolysis in the treatment of acute cerebral infarction.Methods A total of 50 patients with acute cerebral infarction were selected as the research subjects.They were divided into a study group and a control group according to the random number table method,each with 25 cases.The study group was treated with transcranial Doppler ultrasound+0.6 mg/kg low-dose(the highest total dose≤50 mg)alteplase intravenous thrombolysis,and the control group was treated with 0.9 mg/kg alteplase(the highest dose≤90 mg)intravenous thrombolysis.The middle cerebral artery hemodynamics,National Institutes of Health Stroke Scale(NIHSS)score,vascular revascularization rate and adverse reactions were compared between the two groups.Results In the study group,the end-diastolic velocity(Vd),mean velocity(Vm)and peak systolic velocity(Vp)were(23.75±10.25),(40.53±10.15)and(81.26±15.14)cm/s,which were faster than(18.22±7.23),(32.47±10.16)and(70.30±15.12)cm/s in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in NIHSS scores between the two groups before and 2 h after thrombolysis(P>0.05).24 h and 28 d after thrombolysis,the NIHSS scores of the study group were(9.45±1.19)and(7.25±1.17)points,which were lower than(12.33±1.13)and(8.12±1.19)points of the control group,and the differences were statistically significant(P<0.05).The vascular revascularization rate in the control group was 76.00%,which was lower than 96.00%in the study group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the control group was 24.00%,which was higher than 4.00%in the study group,and the difference was statistically significant(P<0.05).Conclusion Transcranial Doppler ultrasound combined with low-dose alteplase intravenous thrombolysis is of high value,which can help patients improve neurological function and hemodynamics,and has pos

关 键 词：急性脑梗死 经颅多普勒超声 小剂量阿替普酶 静脉溶栓 血流动力学 神经功能 不良反应 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]