重组组织型纤溶酶原激活剂治疗急性脑梗死的效果及预后相关因素分析

Effectiveness of intravenous thrombolysis of recombinant tissue-type plasminogenactivator(rtPA)for acute cerebral infarction and the related factors of prognosis

目的探讨重组组织型纤溶酶原激活剂(rtPA)静脉溶栓治疗急性脑梗死的效果及预后相关因素分析。方法选取我院2011-06—2013-10收治的62例急性脑梗死患者作为观察组,在常规治疗基础上总量静滴0.9mg/kg体质量(不超过50mg)rtPA,于1h内滴完。随机选取我院同期收治62例急性脑梗死患者作为对照组。对照组患者给予抗血小板聚集、调脂、降压等常规治疗。采用美国NIHSS评分、Barthel指数(BI)分别记录患者治疗前与治疗后24h、14d、3个月时的评分,评价神经功能恢复状况。并对62例观察组患者的预后影响因素进行单因素分析。结果观察组上述评分术前与对照组无明显差异(P>0.05),而在术后7d、1个月、3个月均显著优于对照组,2组比较差异有统计学意义(P<0.05)。结论 rtPA静脉溶栓治疗急性脑梗死效果较好,预后与年龄、病情轻重、心脏疾病、糖尿病、营养状况等因素有关。

Objective To investigate the effectiveness of intravenous thrombolysis of Recombinant tissue-type plasminoge-nactivator （rtPA） for acute cerebral infarction and the related factors of prognosis.Methods 62 cases of acute cerebral infarc-tion treated in our hospital from June 2011 to October 2013 were selected as the observation group ,anti-platelet aggregation , lowering lipid ,controlling blood pressure and other conventional measures were adopted ,on this basis ,the volume dose of 0.9 mg/kg （no more than 50 mg） rtPA was added by intravenous infusion ,dropped within one hour.And other 62 cases of acute cerebral infarction were randomly selected from June 2011 to October 2013 as the control group.The control group was treated with anti-platelet aggregation ,lowering lipid ,controlling blood pressure and other conventional methods.The United States NIHSS score ,Barthel Index （BI） were recorded respectively to evaluate the recovery of neurological functions before treatment and after the treatment for 24h ,14 days ,3 months.And Single factor analysis was used to analyze the factors influencing the prognosis of patients of observation group.Results The scores of observation group and control group before treatment had no significant difference （P〉0.05） ,while after 7 days ,1 month ,3 months ,the scores were significantly better than those of the control group ,the difference was statistically significance （P〈0.05）.Conclusion The effectiveness of intravenous thromboly-sis of recombinant tissue-type plasminogen activator （rtPA） for acute cerebral infarction is pronounced ,and the prognosis is al-so related with age and severity of heart disease ,diabetes ,nutritional status and other factors.