重组组织型纤溶酶原激活剂治疗心源性脑梗死和非心源性脑梗死的有效性及安全性

Efficacy and safety of recombinant human tissue plasminogen activator in the treatment of cardiogenic cerebral infarction and non-cardiac cerebral infarction

目的:探究重组组织型纤溶酶原激活剂(rt-PA)治疗心源性脑梗死(CCI)和非心源性脑梗死(NCCI)的有效性及安全性。方法:抽取2017年2月至2019年12月由聊城市第三人民医院收治的脑梗死患者90例为研究对象,包括45例CCI患者(A组)和45例NCCI患者(B组),两组均接受rt-PA静脉溶栓治疗,治疗结束后,比较两组美国国立卫生院卒中量表(NIHSS)评分、改良Rankin量表(MRS)评分及并发症发生情况。结果:治疗前,两组NIHSS评分比较差异未见统计学意义(P>0.05),治疗后,两组NIHSS评分显著下降(P<0.05),治疗后7 d与治疗后2 h比较差异有统计学意义(P<0.05),治疗后,两组患者NIHSS评分比较差异未见统计学意义(P>0.05);两组患者治疗前MRS评分比较差异未见统计学意义(P>0.05),治疗后7、30 d,两组MRS评分与治疗前比较显著下降(P<0.05),治疗后30 d与治疗后7 d比较差异有统计学意义(P<0.05),治疗后,两组MRS评分比较差异未见统计学意义(P>0.05);A组皮肤黏膜牙龈出血7例,症状性出血1例,非症状性出血4例,脑疟6例,未见再梗死,总并发症发生率(40.00%)高于B组(15.56%,P<0.05)。结论:rt-PA治疗CCI与NCCI疗效显著,能有效促进患者神经功能恢复,但对CCI患者存在一定风险,会引发多种并发症。

Objective To investigate the efficacy and safety of recombinant human tissue plasminogen activator(rt-PA)in the treatment of cardiogenic cerebral infarction(CCI)and non-cardiac cerebral infarction(NCCI).Methods A total of 90 patients with cerebral infarction in Liaocheng Third People’s Hospital from February 2017 to December 2019 were enrolled,including 45 cases of CCI(group A)and 45 cases of NCCI(group B);both groups received intravenous rt-PA thrombolytic therapy.Then National Institute of Health Stroke Scale(NIHSS)score,modified Rankin scale(MRS)score,and postoperative complications were compared between the two groups after treament.Results Before treatment,there was no statistically significant difference in NIHSS score between the two groups(P>0.05),after treatment,NIHSS score in the two groups decreased significantly(P<0.05).NIHSS score at post-treatment 7 d had significant difference with that at post-treatment 2 h(P<0.05).After treatment,there was no statistically significant difference in NIHSS score between the two groups(P>0.05).There was no statistically significant difference in MRS score between the two groups before treatment(P>0.05).At 7 days and 30 days after treatment,MRS score of the two groups significantly decreased compared with that before treatment(P<0.05),MRS score at 7 days after treatment had significant difference with that at post-treatment 30 d(P<0.05).After treatment,there was no statistically significant difference in MRS score between the two groups(P>0.05).In group A,there were 7 cases of skin,mucosa and gingival bleeding,1 case of symptomatic bleeding,4 cases of asymptomatic bleeding,6 cases of cerebral malaria,and no reinfarction.The incidence rate of complication in group A was significantly higher than that in group B(40.00%vs.15.56%,P<0.05).Conclusions rt-PA is effective for CCI and NCCI patients,which can promote the recovery of neurological function in patients,but rt-PA can cause a variety of complications for CCI patients.