阿替普酶静脉溶栓治疗急性脑梗死的临床观察

Clinical Observation of Alteplase Intravenous Thrombolysis in the Treatment of Acute Cerebral Infarction

目的:观察阿替普酶静脉溶栓治疗急性脑梗死(ACI)患者的出血情况、临床疗效及不良反应。方法:选取ACI患者140例,按随机数字表法分为A组和B组,各70例。A组患者给予阿替普酶0.6 mg/kg行静脉溶栓治疗,B组患者给予阿替普酶0.9 mg/kg行静脉溶栓治疗。对比两组患者溶栓后的出血情况、出血时间、临床疗效及不良反应。结果:A组和B组患者治疗后皮下瘀癍、牙龈出血、消化道出血、颅内出血发生率分别为4.29%和14.29%、2.86%和12.86%、2.86%和11.43%、2.86%和11.43%,出血时间分别为(6.04±0.75)和(7.22±0.56)h、(24.63±10.24)和(35.22±9.87)min、(3.04±0.11)和(4.08±0.25)h、(3.12±0.48)和(4.53±0.66)h,组间比较差异均有统计学意义(P<0.05);治疗后两组患者疗效及不良反应比较,差异无统计学意义(P>0.05)。结论:对ACI患者通过阿替普酶实施静脉溶栓时需严格监测其出血情况,采用较低剂量的阿替普酶实施溶栓治疗,能降低患者出血的发生率。

OBJECTIVE：To observe the bleeding,therapeutic efficacy and ADR of patients with acute cerebral infarction（ACI）treated by alteplase intravenous thrombolysis. METHODS：140 ACI patients were randomly divided into group A and B with 70 cases in each group. Group A was give alteplase 0.6 mg/kg for intravenous thrombolytic therapy,and group B was given alteplase 0.9 mg/kg for intravenous thrombolytic therapy. The bleeding after thrombolysis,bleeding time,therapeutic efficacy and ADR were compared between 2 groups. RESULTS：The incidence of Subcutaneous ecchymosis,gingival bleeding,bleeding of digestive tract and intracranial hemorrhage of group A were 4.29%,2.86%,2.86% and 2.86%;those of group B were 14.29%,12.86%,11.43% and 11.43%;the bleeding time of those symptomsin 2 groups were（6.04±0.75）and（7.22±0.56）h、（24.63±10.24）and（35.22±9.87）min、（3.04±0.11）and（4.08±0.25）h、（3.12±0.48）和（4.53±0.66）h respectirely,with statistical significance（P0.05）. There was no statistical significance in therapeutic efficacy and ADR between 2 groups after treatment（P0.05）.CONCLUSIONS：The bleeding should be monitored strictly when ACI patients receive alteplase intravenous thrombolysis,and low-dose alteplase thrombolysis can ultimately reduce the incidence of bleeding.