急性脑梗死后脑出血患者采用不同剂量同时间窗重组人组织型纤溶酶原激活剂的治疗效果

Effect of recombinant tissue plasminogen activator in different dosages and same time windows in the treatment of patients with cerebral hemorrhage after acute cerebral infarction

目的探讨急性脑梗死后脑出血患者采用不同剂量同时间窗重组人组织型纤溶酶原激活剂(rt-PA)的治疗效果。方法 94例急性脑梗死后脑出血患者,随机分为标准量组与小剂量组,各47例。标准量患组者给予0.9 mg/kg的rt-PA治疗,小剂量组患者给予0.6 mg/kg的rt-PA治疗。比较两组患者治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、日常生活活动能力(ADL)评分及治疗后改良Rankin量表(mRS)评分、治疗效果。结果治疗后,标准量组患者NIHSS评分为(10.4±3.1)分低于治疗前的(16.9±4.9)分、ADL评分为(70.1±9.8)分高于治疗前的(28.4±6.8)分,差异有统计学意义(P<0.05);治疗后,小剂量组患者NIHSS评分为(10.2±3.2)分低于治疗前的(17.1±4.8)分、ADL评分为(72.4±9.5)分高于治疗前的(28.7±6.7)分,差异有统计学意义(P<0.05)。治疗后,两组患者NIHSS评分、ADL评分比较,差异无统计学意义(P>0.05)。治疗后,标准量组患者mRS评分为(1.9±0.4)分,小剂量组患者mRS评分为(1.8±0.5)分,两组比较差异无统计学意义(P>0.05)。两组总有效率比较差异无统计学意义(P>0.05)。结论相同时间窗,小剂量rt-PA治疗急性脑梗死后脑出血患者效果与标准剂量相似,治疗效果好,经济安全,值得临床推广。

Objective To discuss the effect of recombinant tissue plasminogen activator（rt-PA） in different dosages and same time windows in the treatment of patients with cerebral hemorrhage after acute cerebral infarction. Methods A total of 94 patients with cerebral hemorrhage after acute cerebral infarction were randomly divided into standard-dose group and low-dose group, with 47 cases in each group. Standard-dose group was treated with 0.9 mg/kg rt-PA, and the low-dose group was treated with 0.6 mg/kg rt-PA. The National Institutes of Health Stroke scale（NIHSS） score, activity of daily living（ADL） score, modified Rankin scale（m RS） score before and after treatment and treatment effect between the two groups was compared. Results After treatment, standard-dose group had lower NIHSS score as（10.4±3.1） points than（16.9±4.9） points before treatment, and higher ADL score as（70.1±9.8） points than（28.4±6.8） points before treatment. Their difference was statistically significant（P〈0.05）. After treatment, low-dose group had lower NIHSS score as（10.2±3.2） points than（17.1±4.8） points before treatment and higher ADL score as（72.4±9.5） points than（28.7±6.7） points before treatment. Their difference was statistically significant（P〈0.05）. After treatment, both groups had no statistically significant difference in NIHSS score and ADL score（P〉0.05）. After treatment, standard-dose group had m RS score as（1.9±0.4） points, which was（1.8±0.5） points in low-dose group, and the difference was not statistically significant（P〉0.05）. Both groups had no statistically significant different in total effective rate. Conclusion In the same time window, low dose rt-PA shows similar effect to standard dose in the treatment of patients with cerebral hemorrhage after acute cerebral infarction. It provides good treatment effect, and it is economical and safe. It is worthy of clinical promotion.