阿替普酶与尿激酶静脉溶栓在急性脑梗死治疗中的应用及对患者NIHSS评分、MMSE评分的影响

Application of Intravenous Thrombolytic Therapy with Alteplase and Urokinase in Patients with Acute Cerebral Infarction and Its Effect on NIHSS Score and MMSE Score

目的:探讨阿替普酶与尿激酶静脉溶栓治疗急性脑梗死的效果及安全性。方法:回顾性分析2016年3月-2018年2月本院收治的急性脑梗死患者120例,将其按照治疗药物不同分为对照组(n=65)和研究组(n=55)。对照组应用尿激酶静脉溶栓治疗,研究组应用阿替普酶静脉溶栓治疗,观察比较两组患者的临床治疗效果以及安全性。结果:治疗后,研究组患者的治疗总有效率明显高于对照组(P<0.05)。治疗前,两组患者的神经功能缺损评分(NIHSS)比较,差异无统计学意义(P>0.05);治疗后的不同时间点,研究组患者的NIHSS均明显低于对照组(P<0.05)。治疗前,两组患者的MMSE评分比较,差异无统计学意义(P>0.05);治疗后不同时间点,研究组患者MMSE评分均明显高于对照组(P<0.05)。研究组患者并发症的总发生率为10.9%,低于对照组的21.5%,差异有统计学意义(P<0.05)。结论:在急性脑梗死患者的治疗过程中应用阿替普酶,可以达到理想的治疗效果,患者恢复时间较短,并发症的发生率较低,相对比较安全,但是因为经济原因,部分患者仍可应用尿激酶,它也有一定的治疗效果。

Objective：To investigate the efficacy and safety of intravenous thrombolytic therapy with Alteplase and Urokinase in patients with acute cerebral infarction.Method：A retrospective analysis of 120 patients with acute cerebral infarction admitted to our hospital from March 2016 to February 2018,they were divided into control group （n=65） and study group（n=55）,according to the therapeutic drugs.The control group received intravenous thrombolytic therapy with Urokinase,while the study group received intravenous thrombolytic therapy with Alteplase,the clinical efficacy and safety of the two groups were observed and compared.Result：After treatment,the total effective rate of the study group was significantly higher than that of the control group（P〈0.05）.Before treatment,there was no significant difference in neurological deficit score（NIHSS） between the two groups（P〉0.05）,and the NIHSS in the study group was significantly lower than that in the control group at different time points（P〈0.05）.Before treatment,there was no significant difference in MMSE scores between the two groups（P〉0.05）,and the MMSE scores in the study group were significantly higher than those in the control group at different time points（P〈0.05）.The total incidence of complications in the study group was 10.9%,which was lower than 21.5% in the control group（P〈0.05）.Conclusion：In the course of treatment in patients with acute cerebral infarction of Alteplase,can achieve the desired therapeutic effect, patients with shorter recovery time,complication rate is low,relatively safe,but because of economic reasons,some patients can still use Urokinase, it also has a certain therapeutic effect.