重组组织型纤溶酶原激活剂对伴心房颤动急性脑梗死患者的疗效

Curative effect of recombinant tissue plasminogen activator on acute ischemic stroke patients due to atrial fibrillation

目的观察伴心房颤动(房颤)急性脑梗死患者使用重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓的疗效。方法收集发病时间<4.5h的65例应用rt-PA静脉溶栓治疗的急性脑梗死患者,将41例无房颤患者作为非房颤组和24例伴房颤患者作为房颤组;观察溶栓后2组脑出血的发生率、病死率;采用美国国立卫生研究院卒中量表(NIHSS)进行神经功能缺损程度评分;应用改良的Rankin量表(mRS)评估综合生活能力。结果 2组治疗后的NIHSS评分均较治疗前显著降低,且2组各时间点NIHSS评分比较,差异有统计学意义(P<0.05)。2组30d的mRS评分比较,差异有统计学意义(P=0.025)。房颤组脑出血发生率和病死率虽高于非房颤组,但差异均无统计学意义(12.50%vs 2.44%,16.67%vs 2.44%,P>0.05)。结论对于由房颤引起的急性脑梗死患者rt-PA静脉溶栓治疗有效。

Objective To observe the curative effect of recombinant tissue plasminogen activator （rt-PA） on acute ischemic stroke （AIS） due to atrial fibrillation （AF）.Methods Sixty-five AIS patients with their disease onset time 〈4.5 h on intravenous rt-PA thrombolytic therapy were divided into non-AF group （n=41）and AF group （n=24）.The incidence of intracerebral hemorrhage and mortality were observed in the two groups after thrombolytic therapy.Their nerve function defect was scored according to the NIHSS and their living ability was assessed following the mRS.Results The NIHSS and mRS scores were significantly lower in the 2 groups after thrombolytic therapy than before thrombolytic therapy （P〈0.05）.No significant difference was found in the incidence of intracerebral hemorrhage and mortality between the 2 groups although they were higher in AF group than in non-AF group （12.50% vs 2.44%,16.67% vs 2.44%,P〉 0.05）.Conclusion Intravenous rt-PA thrombolytic therapy is effective for AIS due to AF.