纳络酮联合rt-PA治疗急性脑梗死的效果

A STUDY ON EFFICACY OF NALOXONE COMBINED rt-PA THERAPY FOR ACUTE CEREBRAL INFARCTION

目的观察纳络酮联合重组组织型纤溶酶原激活剂(rt-PA)治疗急性脑梗死的临床效果及安全性。方法将50例符合纳入标准的急性脑梗死病人随机分为治疗组和对照组。两组均给予内科常规治疗的同时,治疗组给予纳络酮联合rt-PA治疗,对照组给予rt-PA治疗。以欧洲脑卒中临床神经缺损量表(ESS)和Barthel指数(BI)分别对两组治疗前后神经功能恢复进行评分。结果治疗后14、21d的ESS评分治疗组明显高于对照组,3个月后治疗组的总有效率(88%)明显优于对照组(60%),差异均有统计学意义(t=3.389、4.914,χ2=5.889,P<0.05)。治疗组与对照组出凝血检查和不良反应比较,差异无统计学意义(t=0.316～1.351,P>0.05)。结论在6h内应用纳络酮联合rt-PA治疗急性脑梗死是安全有效的,能显著改善病人的预后。

Objective To observe the therapeutic efficacy and safety of naloxone combined rt-PA therapy for acute cerebral infarction （ACI）. Methods Fifty patients consistent with the inclusion criteria were randomly divided into treatment group and control group. In addition to the routine treatment for both groups, the patients in treatment group were treated with naloxone and rt-PA, and patients in control group with rt-PA. Europe Stroke Scale （ESS） and Barthel Index （BI） were used to evaluate the recovery of neurological function in both groups before and after the treatment. Results ESS integral of 14 days and 21 days after treatment in treatment group was significantly higher than that of patients in control group. The total effective rate （88%） of three months after treatment in treatment group was significantly higher than that （60%） of patients in control group （t= 3. 389,4. 914 χ^2 = 5. 889;P〈0.05）. No significant differences in hemostasis and coagulation, side effects, complications were found between the two groups （t=0. 316-1. 351 ,P〉0.05）. Conclusion The naloxone-rt-PA combination applied within six hours of acute cerebral infarction is safe and effective, which dramatically improves the patients＇ prognosis.