r-PA治疗超急性期脑梗死的疗效观察

The curative effect of r-PA on treating blood pressure of patients with super-acute cerebral infarction

目的观察急性期脑梗死患者使用瑞替普酶（reteplase,r-PA）治疗过程中不同血压对疗效的影响。方法 39例超急性脑梗死患者,符合溶栓条件,美国国立卫生院神经功能缺损评分（National Institutes of Health Stroke Scale,NIHSS）≥4分,采用r-PA 36-54mg行静脉溶栓治疗。动态观察患者溶栓过程中血压变化及NIHSS评分。比较2组入院时、溶栓24h、溶栓2周后NIHSS评分和临床疗效。结果患者溶栓24h及2周后NIHSS评分无明显差异,平均动脉压越高出血风险越大。Logistic回归分析显示,患者溶栓过程中平均动脉压≥105mmHg（1mmHg=0.133kPa）是脑梗死溶栓出血的危险因素（OR=10.833,95%CI=1.974-59.461）。结论 r-PA治疗超急性期脑梗死安全有效,能有效控制患者血压。

Objective To investigate the curative effect of reteplase （r-PA） on treating blood pressure of patients with super-acute cerebral infarction. Methods 39 patients with super-acute cerebral infarction （NIHSS≥ 4 points） were treated with rPA. The blood pressure changes and NIHSS score of patients were monitored during the thrombolytic therapy. The NIHSS score and curative effect of patients were compared on admission, 24 h and 2 weeks after thrombolytic therapy. Results The NIHSS score of patients at 24 h and 2 weeks after thrombolytic therapy had no significant difference, and the higher mean arterial pressure was, the larger the bleeding risk was. Logistic regression analysis showed mean arterial blood pressure more than 105 mmHg （OR= 10. 833,95M CI= 1. 974-59. 461）was risk factors of patients with cerebral infarction during thrombolytic process. Conclusion r-PA has better curative effect on treating patients with cerebral infarction and can effectively control pa tients＇ blood pressure during thrombolytic process.