阿替普酶静脉溶栓治疗急性缺血性脑卒中32例疗效观察

Clinical Observation of Intravenous Thrombolysis with Alteplase for Treating Acute Ischemic Stroke in 32 Cases

目的探讨阿替普酶静脉溶栓治疗急性缺血性脑卒中的疗效和安全性。方法选择医院2016年收治的急性缺血性脑卒中患者(治疗时间窗在4.5 h内)64例,按用药的不同分为两组,各32例。治疗组患者给予阿替普酶静脉溶栓;对照组患者给予阿司匹林等常规治疗。结果治疗组总有效率为93.75%,明显高于对照组的81.25%(P<0.05);治疗6 h,24 h,7 d后,治疗组的美国国立卫生院卒中量表(NIHSS)评分分别为(11.8±3.1)分、(7.5±2.7)分、(5.6±4.5)分,明显低于对照组的(13.5±2.9)分、(9.5±2.1)分、(7.8±3.6)分(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论治疗时间窗小于4.5 h时,阿替普酶静脉溶栓治疗急性缺血性脑卒中疗效显著,安全性好,值得临床推广。

Objective To analyze the clinical effect and safety of intravenous thrombolysis with alteplase for treating acute ischemic stroke. Methods Totally 64 patients with acute ischemic stroke within 4. 5 h in our hospital in 2016 were selected and divided into 2groups according to the different medication,32 cases in each group. The treatment group received intravenous thrombolysis with alteplase,while the control group was given aspirin. Results The total effective rate of the treatment group was 93. 75%,which was significantly higher than 81. 25% of the control group（ P 0. 05）. After 6 h,24 h and 7 d of the treatment,the scores of NIHSS in the treatment group were（ 11. 8 ± 3. 1） points,（ 7. 5 ± 2. 7） points,（ 5. 6 ± 4. 5） points,which were significantly lower than（ 13. 5 ± 2. 9）points,（ 9. 5 ± 2. 1） points,（ 7. 8 ± 3. 6） points in the control group（ P 0. 05）. There was no significant difference in adverse drug reactions between the two groups（ P 0. 05）. Conclusion At the time of therapeutic time window within 4. 5 h,intravenous thrombolysis with alteplase for treating acute ischemic stroke has good effect and safety,which is worthy of clinical promotion.