重组组织型纤溶酶原激活剂静脉溶栓治疗房颤急性缺血性卒中的临床研究

Thrombolytic Therapy with Intravenous Recombinant Tissue-type Plasminogen Activator for Acute Ischemic Stroke Patients with Atrial Fibrillation

目的:探讨重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗房颤及非房颤急性缺血性卒中患者的疗效及安全性。方法:纳入rt-PA静脉溶栓治疗发病4.5 h内急性缺血性卒中患者61例,分为房颤组22例和非房颤组39例。比较2组的基线特征,采用NIHSS及mRS量表评定溶栓前及溶栓后2 h、24 h、7 d、90 d的疗效。结果:房颤组男性人数、起病至开始溶栓时间均低于非房颤组,首次收缩压高于非房颤组,差异均有统计学意义(均P<0.05)。2组溶栓后2 h、24 h、7 d NIHSS评分、7 d疗效、90 d mRS评分差异无统计学意义(P>0.05)。结论:rt-PA治疗房颤急性缺血性卒中患者疗效及安全性与非房颤患者相当。

Objective To investigate the safety and efficacy of thrombolytic therapy with intravenous recombinant tissue-type plasminogen activator （rt-PA） in acute ischemic stroke of patients with or without atrial fibrillation（AF）. Methods： Consecutive acute ischemic stroke patients （n=61） treated with intravenous rt-PA with-in 4.5 h after stroke onset were studied. The patients were divided into groups AF （n=22） and Non-AF（n=39）. The clinical characteristics of the two groups were compared. NIHSS and mRS were used to assess the efficacy and safety before thrombolysis and 2 h, 24 h, 7 d, 90 d respectively after thrombolysis. Results： The percentage of males and the median time for the administration of rt-PA were lower in the AF group then those in the Non-AF group （ P〈0.05）. The prime SBP was higher in the AF group than that in the Non-AF group. There were no significant differences in the NIHSS at 2 h, 24 h, and 7 d, the efficacy at 7 d, and the mRS at 90 d after thrombolysis between the two groups. Conclusion： There were no significant differences in the safety and efficacy of thrombolytic therapy with rt-PA in treating acute ischemic stroke of patients with or without AF.