低于标准剂量的重组组织型纤溶酶原激活剂治疗急性缺血性脑卒中的临床研究

Clinical Study on Low-dose Recombinant Tissue Plasminogen Activator in the Treatment of Acute Ischemic Stroke

目的:评价低于标准剂量的重组组织型纤溶酶原激活剂(rt-PA)治疗急性缺血性脑卒中的疗效。方法:60例急性缺血性脑卒中患者随机分为2组,各30例。患者均于发病后4.5h内给予rt-PA进行溶栓治疗,将低于标准剂量的习惯剂量(0.6mg·kg-1,最大剂量60mg)设为观察组,指南推荐剂量(0.9mg·kg-1,最大剂量90mg)设为对照组。溶栓前、溶栓后4周及治疗2个月后根据中国脑卒中临床神经功能缺损程度评分量表(CSS)对患者的脑功能进行评分,依评分结果判断疗效。结果:溶栓前2组CSS评分比较差异无统计学意义(P>0.05);溶栓后4周2组CSS评分比较差异也无统计学意义(P>0.05);溶栓前与溶栓后4周比较,观察组与对照组CSS评分差异均有统计学意义(P<0.05和P<0.01)。观察组与对照组治疗2个月后有效率分别为86.7%、90.0%(P>0.05)。结论:应用低于标准剂量的rt-PA治疗急性缺血性脑卒中,能收到和标准剂量相同的疗效。

OBJECTIVE：To evaluate the clinical effect of low-dose recombinant tissue plasminogen activator （rt-PA） in the treatment of acute ischemic stroke.METHODS：60 patients with acute ischemic stroke were recruited and randomly divided into 2 groups with 30 cases in each group.All patients were given rt-PA within 4.5 h.The observation group were treated with rt-PA 0.6 mg·kg-1 （maximum dose of 60 mg） and the control group were treated with 0.9 mg·kg-1 （maximum dose of 90 mg）.The cerebral function of patients were evaluated according to CSS before treatment,four weeks and two months after treatment,and then therapeutic efficacy was evaluated.RESULTS：There was no statistical significance in the difference of CSS score between 2 groups before treatment and 4 weeks after treatment （P〉0.05）.Before and 4 weeks after treatment,the CSS scores in the observation group and the control group were significantly different （P0.05）.CONCLUSION：The therapy of low-dose rt-PA obtains same therapeutic efficacy as standard dose for acute ischemic stroke.