重组组织型纤溶酶原激活剂静脉溶栓治疗急性脑梗死疗效分析

Analysis of therapeutic effect in the treatment of acute cerebral infarction by recombinant tissue plasminogen activator

目的探讨急性脑梗死患者使用rt-pA静脉溶栓的临床疗效和出血、死亡风险。方法回顾分析258例在4.5h内就诊的急性脑梗死患者,按是否静脉rt-pA溶栓分为静脉溶栓治疗组(简称溶栓组)和对照组。溶栓组196例患者按0.9mg·kg-1(最大量不超过90mg)静脉给予rt-PA,2组均给予脑梗死常规治疗。比较2组NIHSS评分、临床疗效、出血情况及死亡情况。结果溶栓组治疗后NIHSS评分和临床疗效均优于对照组,差异有统计学意义(P<0.05),且2组颅内出血风险差异无统计学意义(P>0.05)。溶栓组病死率较对照组低,差异有统计学意义(P<0.05)。结论急性脑梗死患者4.5h内应用rt-PA静脉溶栓有显著临床疗效,并未增加颅内出血和死亡风险。

Objective To investigate the clinical efficacy of rt-pA intravenous thrombolysis in patients with acute cerebral infarction and the risk of bleeding and death. Methods A total of 258 patients with acute cerebral infarction who were treated in 4. 5H were retrospectively analyzed. They were divided into intravenous thrombolytic therapy group（thrombolysis group）and control group according to whether rt-PA thrombolysis was performed. 196 patients in the thrombolytic group were given rt-PA by 0.9mg kg^-1（the maximum number of no more than 90mg）,and the two groups were given the routine treatment of cerebral infarction. The NIHSS score,clinical efficacy,bleeding and death in the two groups were compared. Results The NIHSS score and clinical effect of the thrombolysis group were better than those of the control group after treatment, the difference was statistically signifi- cant （P〈0. 05）, and there was no significant difference in intracranial hemorrhage risk between the two groups （P〉0.05）. The mortality of thrombolytic group was lower than that of the control group, and the difference was statistically significant （P〈0.05）. Conclusion The application of rt-PA intravenous thrombolysis in 4.5h for patients with acute cerebral infarction has sig- nificant clinical effect,and it does not increase the risk of intracranial hemorrhage and risk of death