重组组织型纤溶酶原激活剂治疗急性脑梗死的疗效评价

Therapeutic effect evaluation of recombinant tissue plasminogen activator in hyper acute cerebral infarction

目的:评价重组组织型纤溶酶原激活剂(rt-PA)治疗急性脑梗死的疗效及安全性。方法:128例发病<6h的急性脑梗死患者随机分为治疗组和对照组。对照组应用常规治疗方法;治疗组在常规治疗方法的基础上采用rt-PA治疗,总剂量0.9mg/kg,最大剂量90mg,先在1min内静脉注射10%的剂量,其余90%的剂量连续静脉滴注,共计60min。两组治疗前及治疗后2、12、24h及3、7、14、30、90d时均采用《中国脑卒中临床神经功能缺损评分标准》(CSS)及Barthel(BI)指数进行评价。结果:治疗组治疗后各时间点CSS及BI均明显改善(P<0.01),且显效率明显高于对照组(P<0.01),出血发生率低。结论:应用rt-PA治疗急性脑梗死发病<6h更加安全、有效。

Objective： To evaluate the efficacy and safety of recombinant tissue plasminogen activator in hyper acute cerebral infarction. Methods： 128 patients within 6 hours after the onset of stroke were divided into two groups randomly. The people in one group were cured by traditional therapeutic means, while people in another group were given rt-PA in addi- tion to the traditional therapeutic means. Concretely speaking, the total dosage was 0.9 mg/kg, and the maximum dosage was 90 rag. Firstly, 10% of the dosage was injected into vein within 1 minute, then the rest was dropped into vein within 60 minutes. The CSS scores and BI were used to evaluate effects before treatment and at 2 h, 12 h, 24 h, 3 d, 7 d, 14 d, 30 d and 90 d after treatment in two groups. Results： The CSS scores and BI of group two which was given rt-PA were improved at these evaluated time points （P〈0.01）, and efficiency of this group was obviously higher than that of another （P〈0.01）, also the bleeding rate was lower. Conclusion： rt-PA in the treatment of ACI patients within 6 hours after the onset is efficient and safe.