高龄与非高龄急性脑梗死患者不同静脉溶栓方案疗效观察

Therapeutic Effect of Different Intravenous Thrombolytic Drugs for Elderly and Non-senile Patients with Acute Cerebral Infarction

目的:观察与分析高龄与非高龄急性脑梗死患者使用不同静脉溶栓药物治疗的效果。方法:选取2014年8月-2017年12月本院收治的急性脑梗死患者85例。根据不同年龄将其分为≥75岁的高龄组37例(观察组)和<75岁的非高龄组48例(对照组);根据不同溶栓治疗方案将其分为阿替普酶组32例(观察组12例,对照组20例)和尿激酶组53例(观察组25例,对照组28例)。比较各组治疗效果及并发症。结果:不同年龄段治疗前后NIHSS评分改善情况、发病后3个月mRS评分、溶栓并发症发生率比较,差异均无统计学意义(P>0.05);不同溶栓治疗方案治疗前后NIHSS评分改善情况、溶栓并发症发生率比较,差异均有统计学意义(P<0.05);不同溶栓治疗方案发病后3个月mRS评分比较差异无统计学意义(P>0.05)。结论:采用阿替普酶溶栓治疗急性脑梗死患者的短期疗效较尿激酶好,但并发症较多,且对于远期生活质量改善无优势,高龄可能并非静脉溶栓效果及并发症的重要影响因素。

Objective：To observe and analyze the effect of different intravenous thrombolytic drugs in elderly and non-senile patients with acute cerebral infarction.Method：A total of 85 patients with acute cerebral infarction from August 2014 to December 2017 in our hospital were selected.According to different age groups,they were divided into 37 cases of elderly group≥75 years old（observation group） and 48 cases of non-senile grou P75 years old（control group）.According to different thrombolytic therapy,they were divided into 32 cases of Alteplase group（12 cases in observation group and 20 cases in control group） and 53 cases of Urokinase group（25 cases in observation group and 28 cases in control group）.The treatment effects and complications of each group were compared.Result：The improvement of NIHSS score before and after treatment,the mRS score of after onset 3 months,and the incidence of thrombolysis complications were compared between different age groups,the differences were not statistically significant（P〉0.05）.The improvement of NIHSS score before and after treatment,and incidence of thrombolysis complications in different thrombolytic therapy groups was compared,the differences were statistically significant（P〈0.05）.The mRS score of after onset 3 months in different thrombolytic therapy groups was compared,the differences were not statistically significant（P〉0.05）.Conclusion：The short-term efficacy of Alteplase thrombolytic therapy in patients with acute cerebral infarction is better than that of Urokinase,but there are many complications and no advantage in improving long-term quality of life,and advanced age may not be an important factor affecting the efficacy of intravenous thrombolysis and complications.