不同剂量阿替普酶在急性缺血性脑卒中静脉溶栓治疗中的应用效果

Application effect of different doses of alteplase on intravenous thrombolysis therapy of acute ischemic stroke

目的探讨不同剂量阿替普酶在急性缺血性脑卒中静脉溶栓治疗中的应用效果。方法选取开封市祥符区第一人民医院2014年4月—2016年3月收治的急性缺血性脑卒中患者81例,随机分为对照组(n=40)和观察组(n=41)。对照组患者给予低剂量阿替普酶治疗,观察组患者给予标准剂量阿替普酶治疗。观察比较两组患者用药24 h、3个月美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分,临床疗效,血管再通情况,病死、自发性脑出血发生及预后情况。结果观察组患者用药24 h、3个月后NIHSS评分及mRS评分均低于对照组(P<0.05)。两组患者临床疗效比较,差异无统计学意义(P>0.05)。观察组患者阻塞血管再通良好率高于对照组(P<0.05)。两组患者用药7 d、3个月病死率及自发性脑出血发生率比较,差异无统计学意义(P>0.05)。观察组患者预后良好率高于对照组(P<0.05)。结论标准剂量阿替普酶治疗急性缺血性脑卒中,可有效改善患者神经功能缺损程度和生活能力,促进阻塞血管再通,改善预后,且安全性高。

Objective To investigate the application effect of different doses of alteplase on intravenous thrombolysis therapy of acute ischemic stroke. Methods A total of 81 cases of patients with acute ischemic stroke were selected from April2014 to March 2016 in the First People ＇ s Hospital of Kaifeng City Xiangfu District,which were randomly divided into control group（ n = 40） and observation group（ n = 41）. The control group was treated with low-dose alteplase,the observation group was given standard dose of alteplase. The National Institutes of Health Stroke Scale（ NIHSS） score,modified RANKIN scale（ mRS） score after treatment of 24 h,3 months,clinical efficacy,recanalization,death stuation and incidence of spontaneous intracerebral hemorrhage and prognosis were compared between the two groups. Results After treatment of 24 h,3 months,NIHSS scores and mRS scores of observation group were lower than those in control group（ P〈0. 05）. No significant difference of clinical effect was found between the two groups（ P〈0. 05）. The rate of recanalization of observation group was higher than control group（ P〈0. 05）. No significant difference of mortality rate after treatment of 7 days,3 months and incidence of spontaneous cerebral hemorrhage was found between the two groups（ P〈0. 05）. The rate of good prognosis of observation group was higher than control group（ P〈0. 05）. Conclusion The standard dose of alteplase in the treatment of acute ischemic stroke can effectively improve the degree of neurological deficit and the ability of life,promote recanalization,improve the prognosis,and with high safety.